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Xu J, Jiao X, Bayat R. Outcomes of physical exercises on initiation, progression, and treatment of breast cancer. Cell Commun Signal 2024; 22:260. [PMID: 38715015 PMCID: PMC11075339 DOI: 10.1186/s12964-024-01634-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 03/07/2024] [Indexed: 05/12/2024] Open
Abstract
The emergence of drug resistance is a substantial obstacle to the effective management of breast cancer, which is the primary cause of cancer-related deaths in women worldwide. To facilitate the development of targeted therapies that can effectively overcome drug resistance, it is crucial to possess a comprehensive comprehension of the molecular mechanisms that underpin resistance to breast cancer treatment. So far, considerable progress has been made in the field of exercise-oncology research and overcome drug resistance, specifically about breast cancer. Evidence has suggested that participation in physical activity is correlated with a decrease in reappearance and fatality rates of breast cancer patients. It has been reported that participation in physical activity can yield favorable outcomes in the prevention, treatment, and post-treatment of breast cancer. An increasing body of empirical evidence suggests that participation in physical activity can alter diverse biological mechanisms, potentially augmenting breast cancer treatments' efficacy. Comparing increased physical activity versus reduced physical activity in breast cancer patients who received chemotherapy, radiotherapy, and surgery supported the significance of exercise in comprehensive care strategies to enhance overall health and treatment efficacy. Furthermore, previous studies have reported that physical activity can enhance the efficacy of breast cancer treatments. This review provides the current literature regarding the influence of physical activity on the occurrence and progression of breast cancer.
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Affiliation(s)
- Junwei Xu
- Physical education institute, Henan University of Economics and Law, Zhengzhou, China.
| | - Xiance Jiao
- College of Continuing Education, Henan Quality Polytechnic, Pingdingshan, China
| | - Reyhaneh Bayat
- Department of General Surgery, Shahid Beheshti University of Medical Science and Health Services, Taleghani Hospital, Tehran, Iran.
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2
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Kearney N, Connolly D, Begic S, Mockler D, Guinan E. Feasibility metrics of exercise interventions during chemotherapy: A systematic review. Crit Rev Oncol Hematol 2024; 195:104272. [PMID: 38272152 DOI: 10.1016/j.critrevonc.2024.104272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Exercise has been shown to play an important role in managing chemotherapy-related side effects, preserving skeletal muscle mass, and attenuating decline in cardiorespiratory fitness associated with chemotherapy treatment, however, the feasibility of how these exercise programs are being delivered has yet to be synthesized. The objective of this review was to measure the rates of recruitment, adherence, and retention to exercise programs delivered for cancer patients during chemotherapy. METHODS Relevant studies were identified through a search of MEDLINE, Cochrane, EMBASE and CINAHL databases from January 2002 to July 2022 using keywords relating to exercise interventions during chemotherapy. Title and abstract screening, full text review, data extraction, and quality assessment were all performed independently by two reviewers. RESULTS A total of 36 studies were included in the review. The mean recruitment rate for the included studies was 62.39% (SD = 19.40; range 25.7-95%). Travel was the most common reason for declining recruitment in these trials. Adherence rates ranged from 17-109%, however the definition of adherence varied greatly between studies. Mean retention rates for the exercise groups was 84.1% (SD = 12.7; range 50-100%), with chemotherapy side effects being the most common reason why participants dropped out of these trials. CONCLUSION Multiple challenges exist for cancer patients during chemotherapy and careful consideration needs to be given when designing an exercise program for this population. Future research should include public and patient involvement to ensure exercise programs are pragmatic and patient centred.
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Affiliation(s)
- Neil Kearney
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland; Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland.
| | - Deirdre Connolly
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sanela Begic
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - David Mockler
- John Stearne Medical Library, Trinity College Library, Trinity Centre for Health Sciences, Dublin, Ireland
| | - Emer Guinan
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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3
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Liang Z, Zhang M, Shi F, Wang C, Wang J, Yuan Y. Comparative efficacy of four exercise types on obesity-related outcomes in breast cancer survivors: A Bayesian network meta-analysis. Eur J Oncol Nurs 2023; 66:102423. [PMID: 37742423 DOI: 10.1016/j.ejon.2023.102423] [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: 07/18/2023] [Revised: 09/12/2023] [Accepted: 09/16/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE Exercise training is associated with improving the prognosis of breast cancer survivors, but no studies have evaluated the optimal exercise intervention. We aimed to investigate the most effective exercise intervention to improve obesity-related outcomes in breast cancer survivors. METHODS A comprehensive search strategy was conducted in Medline, Embase, Web of Science, Cochrane Library, and Chinese biomedical literature databases from the time of library construction to April 2, 2023. We included randomized controlled trials reporting the effects of four types of exercise interventions (aerobic exercise; aerobic combined with resitance exercise, resitstance exercise and mind-body exercise ) on obesity-related outcomes in breast cancer survivors. A Bayesian network meta-analysis was used to analyze and rank the effectiveness of four exercise types. RESULTS A total of 76 randomized controlled trials that contained 5610 breast cancer survivors were included. The treatment effect of combined aerobic and resistance exercise (mean difference = -0.59; 95% credible interval: 1.15, -0.08) was significantly better than that of the control groups in terms of body mass index. For percentage of body fat, combined aerobic and resistance exercise (mean difference = -1.74; 95% credible interval: 0.87, -0.90) and aerobic exercise (mean difference = -1.16; 95% credible interval: 2.15, -0.16) were significantly better than controls. Subgroup analysis suggested that combined aerobic and resistance exercise significantly affected body mass index at an intervention duration >12 weeks or weekly time on exercise >150 min. CONCLUSION Our network meta-analysis found combined aerobic and resistance exercise may be the most effective intervention to improve obesity-related outcomes in breast cancer survivors. In addition, intervention duration and participant adherence are important factors that influence the effectiveness of exercise interventions.
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Affiliation(s)
- Zhide Liang
- Cancer Institute of the Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, Qingdao, 266071, China.
| | - Meng Zhang
- Xi'an Physical Education University, Xi'an, 710068, China.
| | - Fang Shi
- School of Education and Physical Education, Yangtze University, Jingzhou, 434023, China.
| | - Chuanzhi Wang
- Department of Physical Education, College of Physical Education, Qingdao University, Qingdao, 266071, China.
| | - Jingtai Wang
- Department of Physical Education, College of Physical Education, Qingdao University, Qingdao, 266071, China.
| | - Yang Yuan
- Cancer Institute of the Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, Qingdao, 266071, China.
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Tsai YL, Chuang YC, Chen CP, Lee YC, Cheng YY, Ou-Yang LJ. Feasibility of Aerobic Exercise Training to Mitigate Cardiotoxicity of Breast Cancer Therapy: A Systematic Review and Meta-Analysis. Clin Breast Cancer 2023:S1526-8209(23)00094-0. [PMID: 37286435 DOI: 10.1016/j.clbc.2023.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 04/16/2023] [Accepted: 04/29/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Current anticancer treatments for breast cancer (BC) may cause cardiotoxicity. This study aimed to investigate the effectiveness of aerobic exercise in mitigating cardiotoxicity caused by BC therapy. MATERIALS AND METHODS PubMed, Embase, Cochrane Library, Web of Science, and the Physiotherapy Evidence Database were searched until February 7, 2023. Clinical trials investigating the effectiveness of exercise training, including aerobic exercise, in BC patients receiving treatments that could cause cardiotoxicity were eligible. Outcome measures included cardiorespiratory fitness (CRF) (peak oxygen consumption, VO2peak), left ventricular ejection fraction, and peak oxygen pulse. Intergroup differences were determined by standard mean differences (SMD) and 95% confidence intervals (CIs). Trial sequential analysis (TSA) was utilized to ensure whether the current evidence was conclusive. RESULTS Sixteen trials involving 876 participants were included. Aerobic exercise significantly improved CRF measured by VO2peak in mL/kg/min (SMD 1.79, 95% CI 0.99-2.59) when compared to usual care. This result was confirmed through TSA. Subgroup analyses revealed that aerobic exercise given during BC therapy significantly improved VO2peak (SMD 1.84, 95% CI 0.74-2.94). Exercise prescriptions at a frequency of up to 3 times per week, an intensity of moderate to vigorous, and a >30-minute session length also improved VO2peak. CONCLUSION Aerobic exercise is effective in improving CRF when compared to usual care. Exercise performed up to 3 times per week, at a moderate-to-vigorous intensity, and having a session length >30 minutes is considered effective. Future high-quality research is needed to determine the effectiveness of exercise intervention in preventing cardiotoxicity caused by BC therapy.
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Affiliation(s)
- Yu-Lin Tsai
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ya-Chi Chuang
- Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Carl Pc Chen
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Chun Lee
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan; Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan
| | - Yuan-Yang Cheng
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Liang-Jun Ou-Yang
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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5
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Drillon P, Desvergée A, Prevost V, Blaizot X. [Impact of adapted physical activity on joint pain induced under adjuvant hormone therapy for breast cancer: A review of the literature]. ANNALES PHARMACEUTIQUES FRANÇAISES 2023; 81:1-12. [PMID: 35728629 DOI: 10.1016/j.pharma.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/07/2022] [Accepted: 06/14/2022] [Indexed: 01/07/2023]
Abstract
Hormone therapy provides an excellent survival rate after cancer but has many side effects, including joint pain in one out of two women. This leads about 13 % of women to stop their treatment within the first 6 months, impacting on its effectiveness, survival and the risk of recurrence. In order to better manage pain and quality of life, physical activity is highly recommended. In this context, the present review proposes a state of the art on the effects of adapted physical activity, based on the works referenced in PubMed. These studies show that physical activity has proved its worth in the primary prevention of cancer and is being evaluated in secondary prevention, particularly in the reduction of adverse effects. Overall, there is a reduction in joint pain, an improvement in quality of life and fatigue. Physical activity also plays a role in tertiary prevention. Paradoxically, oncologists and educators often note a reduction in the practice of physical activity due to fear of the onset of pain. It seems necessary to reinforce communication with patients and health professionals and to recommend the practice of physical activity in an appropriate setting.
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Affiliation(s)
- P Drillon
- Pharmacie Le Point du Jour, 36, rue de Cerisé, 61000 Alençon, France
| | - A Desvergée
- Service de Médecine Physique et Réadaptation; Maison Sport Santé (MSS) CHU, Caen Normandie, avenue de la Côte de Nacre, CS 30001, 14033 Caen cedex 9, France
| | - V Prevost
- Centre François Baclesse, 3, avenue du Général Harris, 14000 Caen, France; Normandie Univ, UNICAEN, Inserm, ANTICIPE, 14000 Caen, France
| | - X Blaizot
- Réseau régional de cancérologie de Normandie, 28, rue Bailey, 14000 Caen, France.
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Kang JJ, Lee H, Park BH, Song YK, Park SE, Kim R, Lee KA. Efficacy of a 4-Week Nurse-Led Exercise Rehabilitation Program in Improving the Quality of Life in Women Receiving a Post-Mastectomy Reconstruction Using the Motiva Ergonomix TM Round SilkSurface. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:16. [PMID: 36612340 PMCID: PMC9819378 DOI: 10.3390/ijerph20010016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
We assessed the efficacy of a 4-week nurse-led exercise rehabilitation (ER) program in improving the quality of life (QOL) of breast cancer survivors (BCS) receiving an implant-based breast reconstruction. The eligible patients were equally randomized to either of both groups: the intervention group (n = 30; a 4-week nurse-led ER program) and the control group (n = 30; a 4-week physical therapist-supervised one). Both after a 4-week ER program and at baseline, the patients were evaluated for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Fatigue Severity Scale (FSS) scores. There was a significantly higher degree of increase in global health status/QOL scores, physical functioning scores, role functioning scores, and emotional functioning scores at 4 weeks from baseline in the intervention group as compared with the control group (p = 0.001). However, there was a significantly higher degree of decrease in fatigue scores, nausea/vomiting scores, pain scores, dyspnea scores, and FSS scores in the intervention group as compared with the control group (p = 0.001). In conclusion, our results indicate that a 4-week nurse-led ER program might be effective in the QOL in BCS receiving a post-mastectomy implant-based reconstruction using the Motiva ErgonomixTM Round SilkSurface.
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Affiliation(s)
- Jung Joong Kang
- Department of Physical Medicine and Rehabilitation, Booboo Medical Healthcare Hospital, Mokpo 58655, Republic of Korea
| | - Hyunho Lee
- Department of Anesthesiology and Pain Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea
| | - Bom Hui Park
- Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul 06355, Republic of Korea
| | - Yu Kwan Song
- Department of Plastic and Reconstructive Surgery, Chung Ju Mirae Hospital, Chungju 27361, Republic of Korea
| | - Soon Eun Park
- Department of Anesthesiology and Pain Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea
| | - Robert Kim
- Department of Medical and Pharmaceutical Affairs, Doctor CONSULT, Seoul 06296, Republic of Korea
| | - Kyung Ah Lee
- Department of Plastic and Reconstructive Surgery, Inje University Haeundae Paik Hospital, 875 Haeun-daero, Busan 48108, Republic of Korea
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Briant A, Frandemiche C, Sevin E, Kaluzinski L, Levy C, André M, Rat F, Lucas V, Dadoun N, Segura C, Joly F, Delcambre C, Beauplet B, Lerosier B, Besnier A, Desvergée A, Leconte P, Morello R, Blaizot X. Supervised Physical Activity Quickly Improves Social Dimension of Quality of Life in Breast Cancer Patients. Med Sci Sports Exerc 2022; 54:2158-2166. [PMID: 35881932 DOI: 10.1249/mss.0000000000003005] [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: 11/21/2022]
Abstract
PURPOSE The objectives of the present study was to evaluate the implementation of the program in real life and the evolution of the quality of life (QoL) in breast cancer patients after 3 months of supervised PA in real life and to determine the factors associated with changes in various QoL dimensions. METHODS This prospective cohort study was carried out in female patients with breast cancer diagnosed within a maximum of 3 yr. QoL and physical exertion intensity during the supervised physical activity (PA) sessions were assessed by the Quality of Life Questionnaire for Cancer and Borg scale, respectively. Statistical analyses comparing QoL scores between the start and the end of supervised PA program were assessed using paired Student's t -tests. Multivariate analysis was performed by linear regression with only variables with a P value <0.15 in univariate model. RESULTS A total of 93 patients were included in the analyses. There was a significant improvement of social functioning at T3 (∆ = 11.5; P < 0.001). The improvement of social functioning was significantly and independently associated with the Borg improvement ( β = 2.66 ± 1.31, P = 0.046), chemotherapy ( β = 11.03 ± 5.45, P = 0.046), hormone therapy ( β = -13.91 ± 5.51, P = 0.013), social isolation ( β = -14.81 ± 6.55, P = 0.026), and comorbidities ( β = -15.32 ± 5.59, P = 0.007). CONCLUSIONS We observed a real enthusiasm and need among patients for practicing PA supervised by a sport trainer near their home. The increase in the intensity of exercise over time contributes to the improvement of the QoL, especially on the social functioning. These results, consistent with previous literature, reinforce the importance of exercise intensity on many dimensions of QoL. In addition, patients expressed great satisfaction with the supervised program, resulting in a strong desire to maintain long-term PA.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Bérengère Beauplet
- CHU de Caen et Normandie Univ, UniCaen, INSERM, U1086, ANTICIPE, Caen, FRANCE
| | | | | | - Antoine Desvergée
- CHU de Caen et Normandie Univ, UniCaen, INSERM, U1086, ANTICIPE, Caen, FRANCE
| | | | - Rémy Morello
- Unité de Biostatistique et de Recherche Clinique (UBRC), CHU de Caen Normandie, Caen, FRANCE
| | - Xavier Blaizot
- Réseau Régional de Cancérologie OncoNormandie, Caen, FRANCE
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8
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Sadeghcheh T, Tehrani MS, Faraji H, Azar PA, Helalizadeh M. Analysis of tamoxifen and its main metabolites in plasma samples of breast cancer survivor female athletes: Multivariate and chemometric optimization. J Sep Sci 2022; 45:1362-1373. [PMID: 35138031 DOI: 10.1002/jssc.202100899] [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] [Received: 11/11/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 11/09/2022]
Abstract
A sensitive method based on liquid chromatography combined with a diode array detector was developed and validated to simultaneously determine tamoxifen, and its active metabolites N-desmethyltamoxifen, 4-hydroxytamoxifen, and endoxifen in human plasma samples. The green and sustainable vortex-assisted dispersive liquid-phase microextraction technique based on the natural hydrophobic deep eutectic solvent was used for the extraction and pre-concentration of the analytes. Chemometrics and multivariate analysis were used to optimize the independent variables, including the type and volume of deep eutectic solvent, extraction time, and ionic strength. Under optimal conditions, calibration curves were linear in a suitable range with the lower limits of quantification (0.8-10.0 μg L-1 ), which covered the relevant concentrations of the analytes in plasma samples for a clinical study. Intra- and inter-day precision evaluated at three concentrations for the analytes were lower than 8.2 and 12.1 %, respectively. Accuracy was in the range of 94.9-104.7%. The applicability of the developed method on human plasma samples illustrated the range 45.1-72.8, 98.4-128.3, 0.9-1.2, and 2.7-6.1 μg L-1 for tamoxifen, N-desmethyltamoxifen, 4-hydroxytamoxifen, and endoxifen, respectively. The validated method can be effective for the pharmacokinetics, pharmacodynamics, and therapeutic drug monitoring studies of tamoxifen and its main metabolites in biological fluids. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Tahereh Sadeghcheh
- Department of Chemistry, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mohammad Saber Tehrani
- Department of Chemistry, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Hakim Faraji
- Department of Chemistry, Varamin-Pishva Branch, Islamic Azad University, Varamin, Iran
| | - Parviz Aberoomand Azar
- Department of Chemistry, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Masoumeh Helalizadeh
- Department of Exercise Physiology, Sport Medicine Research Center, Sport Sciences Research Institute, Tehran, Iran
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Lin HP, Kuo YH, Tai WY, Liu HE. Exercise effects on fatigue in breast cancer survivors after treatments: A systematic review and meta-analysis. Int J Nurs Pract 2021; 28:e12989. [PMID: 34258817 DOI: 10.1111/ijn.12989] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 03/15/2021] [Accepted: 06/12/2021] [Indexed: 01/15/2023]
Abstract
AIM The aim of this study is to explore the effects of exercise interventions by type, duration and intensity of exercise for fatigue in breast cancer survivors who had completed their treatment. BACKGROUND Most studies found that exercise has valuable outcomes for cancer survivors. This meta-analysis comprehensively summarizes the benefits of exercise intervention for fatigue in breast cancer patients who had completed their adjuvant treatments. METHODS We conducted a meta-analysis on randomized control trials published during 1 January 2000 through 31 December 2019, from PubMed, Cochrane Library databases, EMBASE, Medline (ProQuest), CINAHL, PsycINFO, Chinese Electronic Periodical Service and Wan Fan Data with prespecified searching criteria. Breast cancer patients earlier than stage IIIc and completing adjuvant treatments were included, and the effects of exercise on fatigue were investigated. RESULTS Nine randomized controlled trials (RCTs) were included (N = 581). Patients receiving exercise interventions showed reduced fatigue comparing with those without exercise. Exercise with low-moderate intensity, 20 min/day, three times per week and lasting up to 12 weeks had a significant effect on reducing fatigue for breast cancer survivors. CONCLUSION Our study suggested that exercise interventions can reduce fatigue for this group of cancer survivors. The duration and intensity of exercise intervention could be prescribed for this specific group of cancer patients as a basic requirement to handle their reported fatigue.
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Affiliation(s)
- Hui-Ping Lin
- Department of Nursing, Tao Yuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsuan Kuo
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wen-Yuan Tai
- Graduate Institute of Sport Promotion, National Taiwan Sport University, Taoyuan, Taiwan
| | - Hsueh-Erh Liu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan, R. O. C.,Department of Rheumatology, Chang Gung Memorial Hospital, Lin Kou & Taoyuan, Taiwan, R. O. C.,Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan, R. O. C
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10
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Lee LL, Huang SF, Lai PC, Huang YT. Effect of exercise on slowing breastfeeding-induced bone loss: A meta-analysis and trial sequential analysis. J Obstet Gynaecol Res 2020; 46:1790-1800. [PMID: 32643316 DOI: 10.1111/jog.14346] [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: 03/20/2020] [Accepted: 05/19/2020] [Indexed: 11/28/2022]
Abstract
AIM This study systematically reviewed evidence regarding the effectiveness of exercise in slowing breastfeeding-induced bone loss. METHODS The evidence-based approach of a systematic review (PROSPERO registration No. CRD42019111623) was adopted. The inclusion criteria were randomized controlled trials or observational studies. Study samples were breastfeeding women, the intervention was any form of exercise, and bone mineral density (BMD) of the total body, lumbar spine and hip/femur neck before 6 months and at 1 year were the outcome measures. Meta-analyses were performed using a random effect model, and calculations of mean differences of BMD change and 95% confidence intervals (CIs) were carried out. Studies were further evaluated through trial sequential meta-analysis (TSA), and the 'Grading of Recommendations Assessment, Development and Evaluation' methodology was used to assess the certainty of evidence (CoE). RESULTS A total of 1049 studies were screened, and 4 met the inclusion criteria. Weight-bearing aerobic exercise and resistance training before the 6-month evaluation slowed breastfeeding-induced bone loss in the lumbar spine (1.62% BMD change [95% CI = 0.53-2.71]; I2 = 8%). The TSA Z-curve revealed crossing of the TSA boundary and line of information size, indicating sufficient sampling and significance. The CoE of exercise benefit in the lumbar spine at 6 months was low, whereas the CoE for other areas ranged from low to very low. CONCLUSION This first systematic review and meta-analysis provided some evidence of the advantages of exercise for slowing breastfeeding-induced bone loss. However, additional randomized controlled trials are warranted to generate more conclusive evidence.
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Affiliation(s)
- Ling-Ling Lee
- Department of Nursing, College of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Sen-Fang Huang
- Center for Physical Education Teaching, College of Education and Communication, Tzu Chi University, Hualien, Taiwan
| | - Pei-Chun Lai
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.,Evidence-based Medicine Center, Department of Medical Education, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Yen-Ta Huang
- Division of Experimental Surgery, Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.,Department of Pharmacology, School of Medicine, Tzu Chi University, Hualien, Taiwan
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Boing L, Vieira MDCS, Moratelli J, Bergmann A, Guimarães ACDA. Effects of exercise on physical outcomes of breast cancer survivors receiving hormone therapy - A systematic review and meta-analysis. Maturitas 2020; 141:71-81. [PMID: 33036706 DOI: 10.1016/j.maturitas.2020.06.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/14/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Side-effects of hormone therapy can impair the physical health of breast cancer survivors. Exercise has been clearly shown to improve the quality of life of breast cancer survivors. Less is known about the effects of exercise on physical outcomes for breast cancer survivors receiving hormone therapy. OBJECTIVE To investigate the effects of exercise on physical outcomes of breast cancer survivors receiving hormone therapy. METHODS Five electronic databases were searched by two authors using the terms "Breast Neoplasms" [MeSH] and "Tamoxifen" [MeSH] and "Aromatase Inhibitors" [MeSH] and "Exercise" [MeSH]. Randomized and non-randomized clinical trials were included. Risk of bias was assessed by the Cochrane Collaboration tool and ROBINS-I, and the quality of evidence was evaluated using GRADE. Pooled effects were reported as standardized mean differences (SMDs) and 95 % confidence intervals (CIs) using a random effects model. RESULTS Eleven studies were included in the meta-analysis. Two hundred and fourteen breast cancer survivors receiving hormone therapy, tamoxifen, or aromatase inhibitors participated in interventions based on aerobic plus resistance exercise or walking activity. The physical outcomes reported in the articles were: cardiorespiratory fitness, pain, bone mineral density, grip strength, and body fat percentage. Exercise effects were found only for cardiorespiratory fitness (SMD = 0.37; 95 % CI: 0.11; 0.63; I2 = 93 %) and pain (SMD = -0.55; IC95 % -1.11; -0.00; I2 = 80 %), with low quality of evidence. No effects were observed for the other variables. CONCLUSIONS Aerobic plus resistance exercise had positive effects on cardiorespiratory fitness and pain in breast cancer survivors receiving hormone therapy. However, high-quality randomized clinical trials are required to confirm this finding.
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Affiliation(s)
- Leonessa Boing
- College of Health and Sport Science, Santa Catarina State University, Brazil.
| | | | - Jéssica Moratelli
- College of Health and Sport Science, Santa Catarina State University, Brazil
| | - Anke Bergmann
- Clinical Research Program, National Cancer Institute, Brazil
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Møller T, Andersen C, Lillelund C, Bloomquist K, Christensen KB, Ejlertsen B, Tuxen M, Oturai P, Breitenstein U, Kolind C, Travis P, Bjerg T, Rørth M, Adamsen L. Physical deterioration and adaptive recovery in physically inactive breast cancer patients during adjuvant chemotherapy: a randomised controlled trial. Sci Rep 2020; 10:9710. [PMID: 32546796 PMCID: PMC7297957 DOI: 10.1038/s41598-020-66513-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 05/18/2020] [Indexed: 12/22/2022] Open
Abstract
Cardiorespiratory fitness is an independent risk factor for cardiovascular disease and shortened life expectancy in breast cancer survivors. This randomised controlled trial (n = 153) was designed for patients with a physically inactive lifestyle prediagnosis and concurrently referred to adjuvant chemotherapy. We compared two 12-week exercise interventions aimed at physiological and patient-reported outcomes (cardiorespiratory fitness, muscle strength, metabolic markers, physical activity, pain, fatigue), including a 39-week follow-up. A supervised hospital-based moderate to high intensity group exercise intervention was compared to an instructed home-based individual pedometer intervention. The two 12-week interventions included oncologists’ recommendations and systematic health counselling. Outcomes were measured at baseline and week 6, 12 and 39. Primary outcome cardiorespiratory fitness declined significantly during chemotherapy and was restored in both interventions at follow-up. The interventions effectively engaged breast cancer patients in sustaining physical activities during and following adjuvant treatment. A composite metabolic score improved significantly. Positive cardiorespiratory fitness responders had improved clinical effects on fatigue, pain and dyspnoea versus negative responders. We conclude that a loss of cardiorespiratory fitness among physically inactive breast cancer patients may be restored by early initiated interventions and by adapting to physical activity recommendations, leading to a decreased cardiovascular risk profile in breast cancer survivors.
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Affiliation(s)
- Tom Møller
- The University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Department, 9701, Copenhagen, Denmark. .,University of Copenhagen, Faculty of Health and Medical Sciences, Department of Public Health, Copenhagen, Denmark.
| | - Christina Andersen
- The University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Department, 9701, Copenhagen, Denmark
| | - Christian Lillelund
- The University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Department, 9701, Copenhagen, Denmark
| | - Kira Bloomquist
- The University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Department, 9701, Copenhagen, Denmark
| | - Karl Bang Christensen
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Public Health, Copenhagen, Denmark
| | - Bent Ejlertsen
- Copenhagen University Hospital, Rigshospitalet, Department of Oncology, 7301, Copenhagen, Denmark
| | - Malgorzata Tuxen
- Copenhagen University Hospital, Rigshospitalet, Department of Oncology, 7301, Copenhagen, Denmark
| | - Peter Oturai
- Copenhagen University Hospital, Rigshospitalet, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen, Denmark
| | - Ulla Breitenstein
- Copenhagen University Hospital, Rigshospitalet, Department of Oncology, 7301, Copenhagen, Denmark
| | - Cecilie Kolind
- Copenhagen University Hospital, Herlev Hospital, Department of Oncology, Herlev, Denmark
| | - Pernille Travis
- Copenhagen University Hospital, Herlev Hospital, Department of Oncology, Herlev, Denmark
| | - Tina Bjerg
- Copenhagen University Hospital, Rigshospitalet, Department of Oncology, 7301, Copenhagen, Denmark
| | - Mikael Rørth
- Copenhagen University Hospital, Rigshospitalet, Department of Oncology, 7301, Copenhagen, Denmark
| | - Lis Adamsen
- The University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Department, 9701, Copenhagen, Denmark.,University of Copenhagen, Faculty of Health and Medical Sciences, Department of Public Health, Copenhagen, Denmark
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13
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Ninot G, Flori N, Huteau ME, Stoebner-Delbarre A, Senesse P. Activités physiques et cancers : des bénéfices prouvés pendant et après les traitements. Bull Cancer 2020; 107:474-489. [DOI: 10.1016/j.bulcan.2019.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 09/18/2019] [Accepted: 11/29/2019] [Indexed: 01/15/2023]
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Gür F, Can Gür G. Is Exercise a Useful Intervention in the Treatment of Alcohol Use Disorder? Systematic Review and Meta-Analysis. Am J Health Promot 2020; 34:520-537. [PMID: 32212949 DOI: 10.1177/0890117120913169] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis examined the effects of exercise on individuals with alcohol use disorders (AUDs) across multiple health outcomes. DATA SOURCES PubMed, Medline, Web of Science, Scopus, Academic Search complete, Sport Discuss, and ERIC databases. STUDY INCLUSION AND EXCLUSION CRITERIA Interventional studies published between 2000 and 2018 focused on evaluating the effectiveness of exercise interventions in adults with AUD. DATA EXTRACTION This protocol was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols standard and the Meta-Analyses and Systematic Reviews of Observational Studies guidelines. DATA SYNTHESIS Physical activity levels/fitness [VO2 max (Oxygen Uptake) and HRmax (Maximum Heart Rate)], levels of depression, anxiety, self-efficacy, quality of life, and alcohol consumption (number of standard drinks consumed per day and per week). RESULTS The findings indicated that exercise significantly improved physical fitness as assessed by VO2 max (standardized mean difference [SMD]: 0.487, P < .05) and HRmax (SMD: 0.717, P < .05). Similarly, exercise significantly improved mental health as assessed by quality of life (SMD: 0.425, P < .05), but levels of depression, anxiety, self-efficacy, and alcohol consumption did not change significantly. Aerobic exercise alleviated depression and anxiety symptoms more than that of yoga and mixed types. Duration of exercise also had a similar effect on anxiety and depression. CONCLUSIONS Exercise can be an effective and persistent adjunctive treatment for individuals with AUDs.
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Affiliation(s)
- Fatih Gür
- Faculty of Sport Science, University of Pamukkale, Pamukkale, Turkey
| | - Ganime Can Gür
- Faculty of Sport Science, University of Pamukkale, Pamukkale, Turkey
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15
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Boing L, do Bem Fretta T, de Carvalho Souza Vieira M, Pereira GS, Moratelli J, Sperandio FF, Bergmann A, Baptista F, Dias M, de Azevedo Guimarães AC. Pilates and dance to patients with breast cancer undergoing treatment: study protocol for a randomized clinical trial - MoveMama study. Trials 2020; 21:35. [PMID: 31910872 PMCID: PMC6947954 DOI: 10.1186/s13063-019-3874-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 11/02/2019] [Indexed: 12/31/2022] Open
Abstract
Background Breast cancer is a global public health issue. The side effects of the clinical treatment can decrease the quality of life of these women. Therefore, a healthy lifestyle is essential to minimize the physical and psychological side effects of treatment. Physical activity has several benefits for women with breast cancer, and Pilates solo and belly dancing can be an enjoyable type of physical activity for women with breast cancer undergoing clinical treatment. The purpose of this study is to provide a Pilates solo and a belly dance protocol (three times per week/16 weeks) for women undergoing breast cancer treatment and compare its effectiveness with that in the control group. Methods The participants will be allocated to either the intervention arm (Pilates solo or belly dance classes three times per week for 16 weeks) or a control group (receipt of a booklet on physical activity for patients with breast cancer and maintenance of habitual physical activity routine). The Pilates solo and belly dance classes will be divided into three stages: warmup and stretching, the main stage, and relaxation. Measurements of the study outcomes will take place at baseline; postintervention; and 6, 12, and 24 months after the end of the intervention (maintenance period). The data collection for both groups will occur with a paper questionnaire and tests covering general and clinical information. The primary outcome will be quality of life (EORT QLQ-C30 and EORT QLQ-BR23), and secondary outcomes will be physical aspects such as cardiorespiratory fitness (6-min walk test and cycle ergometer), lymphedema (sum of arm circumference), physical activity (IPAQ short version), disabilities of the arm (DASH), range of motion (goniometer test), muscular strength (dynamometer test) and flexibility (sit and reach test), and psychological aspects such as depressive symptoms (Beck Depression Inventory), body image (Body Image After Breast Cancer Questionnaire), self-esteem (Rosenberg), fatigue (FACT-F), pain (VAS), sexual function (FSFI), and sleep quality (Pittsburgh Sleep Quality Index). Discussion In view of the high prevalence of breast cancer among women, the implementation of a specific protocol of Pilates solo and belly dancing for patients with breast cancer is important, considering the necessity to improve their physical and psychological quality of life. Pilates solo and belly dancing are two types of physical activity that involve mental and physical concentration, music, upper limb movements, femininity, and social involvement. An intervention with these two physical activities could offer options of supportive care to women with breast cancer undergoing treatment, with the aim being to improve physical and psychological quality of life. Trial registration ClinicalTrials.gov, NCT03194997. Registration date 12 August 2017. Universal Trial Number (World Health Organization), U1111-1195-1623.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Mirella Dias
- Santa Catarina State University, Florianópolis, Brazil
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16
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Bekhet AH, Abdalla AR, Ismail HM, Genena DM, Osman NA, El Khatib A, Abbas RL. Benefits of Aerobic Exercise for Breast Cancer Survivors: A Systematic Review of Randomized Controlled Trials. Asian Pac J Cancer Prev 2019; 20:3197-3209. [PMID: 31759342 PMCID: PMC7063018 DOI: 10.31557/apjcp.2019.20.11.3197] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 09/10/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Physical exercise may be beneficial to breast cancer (BC) survivors. Here, we systematically summarized the effects of aerobic exercise in BC survivors. We conducted a systematic review of randomized controlled trials (RCTs). METHODS We searched PubMed, Web of knowledge, Scopus, Cochrane Central, Virtual Health Library and PEDRO databases for relevant RCTs, comparing aerobic exercise with usual care among BC survivors. Data were extracted and evidence was synthesized narratively. RESULTS Twelve studies were included in this systematic review. Studies reported that aerobic exercise can significantly improve the quality of life in BC survivors. Moreover, aerobic exercise alleviated the symptoms of depression and anxiety. However, current evidence from the included studies showed that there was no significant benefit for aerobic exercise in terms of weight loss. CONCLUSION Our study suggests that aerobic exercise is beneficial to BC survivors. CLINICAL RELEVANCE Aerobic exercise should be recommended in the therapeutic and rehabilitative regimens of BC survivors. .
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Affiliation(s)
- Amira Hassan Bekhet
- Faculty of Physical Therapy, Cairo University,
- Medical Research Group of Egypt Cairo,
| | | | - Horeya M Ismail
- Medical Research Group of Egypt Cairo,
- Cancer Research Cluster,
| | - Doaa M Genena
- Medical Research Institute, Alexandria, University, Alexandria, Egypt,
| | - Nermin A Osman
- Medical Research Institute, Alexandria, University, Alexandria, Egypt,
| | - Ayman El Khatib
- Department of Physical Therapy, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.
| | - Rami Labib Abbas
- Department of Physical Therapy, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.
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17
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Penttinen H, Utriainen M, Kellokumpu-Lehtinen PL, Raitanen J, Sievänen H, Nikander R, Blomqvist C, Huovinen R, Vehmanen L, Saarto T. Effectiveness of a 12-month Exercise Intervention on Physical Activity and Quality of Life of Breast Cancer Survivors; Five-year Results of the BREX-study. In Vivo 2019; 33:881-888. [PMID: 31028212 PMCID: PMC6559915 DOI: 10.21873/invivo.11554] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 02/28/2019] [Accepted: 03/05/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND/AIM This is a report of the 5-year quality of life (QoL) findings of the BREX-study (n=444). PATIENTS AND METHODS A 12-month exercise intervention was arranged shortly after adjuvant treatments. Physical activity (PA) was assessed by PA diary, physical performance by a 2- km walking test, QoL by the EORTC QLQC30 and BR-23 questionnaires, fatigue by the FACIT-Fatigue scale and depression by the Beck's 13-item depression scale (BDI). RESULTS Participants who improved their PA from baseline to 5-year follow-up were more likely to improve their global health score (RRR=1.02, p=0.016), physical (RRR=1.02, p=0.009), social (RRR=1.03, p=0.013), role functioning (RRR=1.03, p=0.005), and fatigue (RRR=1.02, p=0.002). An improved 2-km walking test was associated to improved global health, physical and role functioning, body image, future perspectives, and fatigue (p=0.011, p<0.001, p=0.001, p=0.021, p=0.012 and p=0.003). No significant difference between the groups was found. CONCLUSION Improvement in PA or physical performance yields a positive change in QoL of breast cancer patients.
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Affiliation(s)
- Heidi Penttinen
- Helsinki University Hospital, Comprehensive Cancer Center, and Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Meri Utriainen
- Helsinki University Hospital, Comprehensive Cancer Center, and Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Pirkko-Liisa Kellokumpu-Lehtinen
- Department of Oncology, Tampere University Hospital and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Jani Raitanen
- UKK Institute for Health Promotion Research, Tampere, Finland
- Faculty of Social Sciences (Health Sciences), University of Tampere, Tampere, Finland
| | - Harri Sievänen
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Riku Nikander
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Carl Blomqvist
- Helsinki University Hospital, Comprehensive Cancer Center, and Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Riikka Huovinen
- Department of Oncology, Turku University Hospital and Faculty of Medicine, University of Turku, Turku, Finland
| | - Leena Vehmanen
- Helsinki University Hospital, Comprehensive Cancer Center, and Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tiina Saarto
- Helsinki University Hospital, Comprehensive Cancer Center, and Faculty of Medicine, University of Helsinki, Helsinki, Finland
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18
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Foucaut AM, Morelle M, Kempf-Lépine AS, Baudinet C, Meyrand R, Guillemaut S, Metzger S, Bourne-Branchu V, Grinand E, Chabaud S, Pérol D, Carretier J, Berthouze SE, Reynes E, Perrier L, Rebattu P, Heudel PE, Bachelot T, Bachmann P, Fervers B, Trédan O, Touillaud M. Feasibility of an exercise and nutritional intervention for weight management during adjuvant treatment for localized breast cancer: the PASAPAS randomized controlled trial. Support Care Cancer 2019; 27:3449-3461. [DOI: 10.1007/s00520-019-4658-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 01/16/2019] [Indexed: 01/05/2023]
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19
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Lambert M, Brunet J, Couture-Lalande ME, Bielajew C. Aerobic physical activity and salivary cortisol levels among women with a history of breast cancer. Complement Ther Med 2019; 42:12-18. [PMID: 30670229 DOI: 10.1016/j.ctim.2018.10.018] [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: 09/17/2018] [Revised: 10/10/2018] [Accepted: 10/22/2018] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Physical activity (PA) helps reduce cancer-related symptoms and improves overall functioning for women with and without a history of breast cancer (BC). Few researchers have examined the associations between PA and physiological stress measures. The aim of this study was to determine whether aerobic PA was associated with diurnal and reactive cortisol patterns, and whether these associations differed for women with and without a history of BC. METHODS Participants were 25 women with a history of BC and 23 women without a history of BC who self-reported aerobic PA frequency. To assess diurnal cortisol patterns, participants provided five saliva samples collected on two consecutive days at the following times: upon awakening, 30 min after waking, 12 PM, 4 PM, and 9 PM. To measure reactive cortisol patterns, participants provided seven saliva samples collected before, during, and after doing the Trier Social Stress Test. RESULTS Cortisol patterns differed statistically based on women's cancer history, whereby women without a history of BC had significantly higher overall cortisol reactivity to an acute stressor, and a marginally significant (p = .05) cancer experience by aerobic PA interaction was observed when analyzing diurnal cortisol data. CONCLUSIONS Findings suggest that PA may not have the same effect on women with and without a history of BC.
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Affiliation(s)
- M Lambert
- School of Psychology, University of Ottawa, Ontario, Canada.
| | - J Brunet
- School of Psychology, University of Ottawa, Ontario, Canada; School of Human Kinetics, University of Ottawa, Ontario, Canada
| | | | - C Bielajew
- School of Psychology, University of Ottawa, Ontario, Canada
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20
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Fuller JT, Hartland MC, Maloney LT, Davison K. Therapeutic effects of aerobic and resistance exercises for cancer survivors: a systematic review of meta-analyses of clinical trials. Br J Sports Med 2018; 52:1311. [PMID: 29549149 DOI: 10.1136/bjsports-2017-098285] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To systematically appraise and summarise meta-analyses investigating the effect of exercise compared with a control condition on health outcomes in cancer survivors. DESIGN Umbrella review of intervention systematic reviews. DATA SOURCES Web of Science, Scopus, Cochrane Library, CINAHL and MEDLINE databases were searched using a predefined search strategy. ELIGIBILITY CRITERIA Eligible meta-analyses compared health outcomes between cancer survivors participating in an exercise intervention and a control condition. Health outcomes were cardiovascular fitness, muscle strength, health-related quality of life, cancer-related fatigue and depression. Pooled effect estimates from each meta-analysis were quantified using standardised mean differences and considered trivial (<0.20), small (0.20-0.49), moderate (0.50-0.79) and large (≥0.80). Findings were summarised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS There were 65 eligible articles that reported a total of 140 independent meta-analyses. 139/140 meta-analyses suggested a beneficial effect of exercise. The beneficial effect was statistically significant in 104 (75%) meta-analyses. Most effect sizes were moderate for cardiovascular fitness and muscle strength and small for cancer-related fatigue, health-related quality of life and depression. The quality of evidence was variable according to the GRADE scale, with most studies rated low or moderate quality. Median incidence of exercise-related adverse events was 3.5%. CONCLUSION Exercise likely has an important role in helping to manage physical function, mental health, general well-being and quality of life in people undergoing and recovering from cancer and side effects of treatment. PROSPERO REGISTRATION NUMBER CRD42015020194.
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Affiliation(s)
- Joel T Fuller
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.,Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Michael C Hartland
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Luke T Maloney
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Kade Davison
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
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21
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Chang IY, Yi ES. The influence of environmental constraints within hospitals on physical activity level of cancer patients. J Exerc Rehabil 2018; 14:382-386. [PMID: 30018922 PMCID: PMC6028198 DOI: 10.12965/jer.1836240.120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 05/10/2018] [Indexed: 01/04/2023] Open
Abstract
This study aims to examine the influence of hospital environmental constraints on physical activity level of cancer patients. The subjects of this study were 194 cancer patients from five general hospitals in the Seoul metropolitan area (Seoul, Gyeonggi-do, and Incheon). The collected data was analyzed by using SPSS ver. 23.0. As a result of analyzing the effect of environmental constraints on the physical activity level of cancer patients, the constraints related to hospital facilities and programs had no effect on patients’ time spent in a hospital bed and their time spent on daily. However, the time cancer patients spend on intentional physical movements is affected by hospital facilities or programs. This means that hospital facilities or programs play an important role in patients’ intentional physical activities. In conclusion, for hospitalized cancer patients, physical activity levels are influenced by environmental constraints in the hospital. Therefore, it is important to improve the hospital environment to increase physical activities such as walking and physical exercise, which are an important factor for cancer recovery and prevention of recurrence.
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Affiliation(s)
- Ik Young Chang
- Department of Community Sport, Korea National Sport University, Seoul, Korea
| | - Eun-Surk Yi
- Department of Exercise Rehabilitation and Welfare, College of Health Science, Gachon University, Incheon, Korea
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22
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Singh B, Spence RR, Steele ML, Sandler CX, Peake JM, Hayes SC. A Systematic Review and Meta-Analysis of the Safety, Feasibility, and Effect of Exercise in Women With Stage II+ Breast Cancer. Arch Phys Med Rehabil 2018; 99:2621-2636. [PMID: 29730319 DOI: 10.1016/j.apmr.2018.03.026] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/24/2018] [Accepted: 03/23/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To systematically evaluate the safety, feasibility, and effect of exercise among women with stage II+ breast cancer. DATA SOURCES CINAHL, Cochrane, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, Science Direct and SPORTDiscus were searched for articles published before March 1, 2017. STUDY SELECTION Randomized, controlled, exercise trials involving at least 50% of women diagnosed with stage II+ breast cancer were included. DATA EXTRACTION Risk of bias was assessed and adverse event severity was classified using the Common Terminology Criteria. Feasibility was evaluated by computing median (range) recruitment, withdrawal, and adherence rates. Meta-analyses were performed to evaluate exercise safety and effects on health outcomes only. The influence of intervention characteristics (mode, supervision, duration and timing) on exercise outcomes were also explored. DATA SYNTHESIS There were no differences in adverse events between exercise and usual care (risk difference: <0.01 ([95% CI: -0.01, 0.01], P=0.38). Median recruitment rate was 56% (1%-96%), withdrawal rate was 10% (0%-41%) and adherence rate was 82% (44%-99%). Safety and feasibility outcomes were similar, irrespective of exercise mode, supervision, duration, or timing. Effects of exercise for quality of life, fitness, fatigue, strength, anxiety, depression, body mass index and waist circumference compared with usual care were significant (standardized mean difference range: 0.17-0.77, P<0.05). CONCLUSION The findings support the safety, feasibility, and effects of exercise for those with stage II+ breast cancer, suggesting that national and international exercise guidelines appear generalizable to women with local, regional, and distant breast cancer.
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Affiliation(s)
- Ben Singh
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Musk Avenue, Kelvin Grove, Queensland, Australia.
| | - Rosalind R Spence
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Musk Avenue, Kelvin Grove, Queensland, Australia
| | - Megan L Steele
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Musk Avenue, Kelvin Grove, Queensland, Australia
| | - Carolina X Sandler
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Musk Avenue, Kelvin Grove, Queensland, Australia; Cancer Prevention Research Centre, School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Jonathan M Peake
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Musk Avenue, Kelvin Grove, Queensland, Australia; School of Biomedical Sciences, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, Australia
| | - Sandra C Hayes
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Musk Avenue, Kelvin Grove, Queensland, Australia
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D’Souza V, Daudt H, Kazanjian A. Survivorship care plans for breast cancer patients: understanding the quality of the available evidence. Curr Oncol 2017; 24:e446-e465. [PMID: 29270054 PMCID: PMC5736484 DOI: 10.3747/co.24.3632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
AIM The overall goal of the present study was to contribute to consistency in the provincial approach to survivorship care planning through knowledge synthesis and exchange. Our review focused on the research concerning the physical and emotional challenges of breast cancer (bca) patients and survivors and the effects of the interventions that have been used for lessening those challenges. METHODS The psychosocial topics identified in bca survivorship care plans created by two different initiatives in our province provided the platform for our search criteria: quality of life (qol), sexual function, fatigue, and lifestyle behaviours. We conducted an umbrella review to retrieve the best possible evidence, and only reviews investigating the intended outcomes in bca survivors and having moderate-to-high methodologic quality scores were included. RESULTS Of 486 reports retrieved, 51 reviews met the inclusion criteria and form part of the synthesis. Our results indicate that bca patients and survivors experience numerous physical and emotional challenges and that interventions such as physical activity, psychoeducation, yoga, and mindfulness-based stress reduction are beneficial in alleviating those challenges. CONCLUSIONS Our study findings support the existing survivorship care plans in our province with respect to the physical and emotional challenges that bca survivors often face. However, the literature concerning cancer risks specific to bca survivors is scant. Although systematic reviews are considered to be the "gold standard" in knowledge synthesis, our findings suggest that much remains to be done in the area of synthesis research to better guide practice in cancer survivorship.
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Affiliation(s)
- V. D’Souza
- BC Cancer Agency–Vancouver Island Centre, Victoria, BC
| | - H. Daudt
- BC Cancer Agency–Vancouver Island Centre, Victoria, BC
| | - A. Kazanjian
- BC Cancer Agency–Vancouver Island Centre, Victoria, BC
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC
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Knobf MT, Jeon S, Smith B, Harris L, Thompson S, Stacy MR, Insogna K, Sinusas AJ. The Yale Fitness Intervention Trial in female cancer survivors: Cardiovascular and physiological outcomes. Heart Lung 2017; 46:375-381. [PMID: 28803675 PMCID: PMC6129386 DOI: 10.1016/j.hrtlng.2017.06.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/31/2017] [Accepted: 06/12/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Induced premature menopause and cardio-toxic therapy increase cardiovascular disease risk in female cancer survivors. OBJECTIVE To compare the effects of a 12 month aerobic-resistance fitness center intervention to home based physical activity on cardiovascular function and metabolic risk factors. METHODS Subjects (N = 154) who had completed primary and/or adjuvant chemotherapy (past 3 years) were randomized to a fitness center intervention or a home based group. The fitness center intervention was a structured thrice weekly aerobic (30 min brisk walking treadmill in target heart range) combined with resistance (30 min of lower body strength training) exercise program, supervised for the first 6 months. The home based group received national guidelines for 30 min moderate intensity exercise most days of the week. Fasting serum samples were collected at baseline, 6 and 12 months for insulin, glucose, lipids and hemoglobin A-1C. A graded exercise stress test was also performed at baseline and 6 months. RESULTS The majority of subjects were white (85.7%), had breast cancer (83.1%) and the average age was 51.9 years. Subjects in the fitness center intervention had significantly improved time on treadmill (p = .039), improved heart rate recovery at 1 min (p = .028), greater MET minutes/week (p ≤ .0001), a trend for improved insulin resistance (p = .067) and stable insulin levels (p = .045) compared to the home based physical activity group. CONCLUSIONS Exercise represents a potential cardiac risk reduction intervention for cancer survivors. CLINICAL TRIALS.GOV: NCT01102985.
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Pasanen T, Tolvanen S, Heinonen A, Kujala UM. Exercise therapy for functional capacity in chronic diseases: an overview of meta-analyses of randomised controlled trials. Br J Sports Med 2017; 51:1459-1465. [PMID: 28500079 DOI: 10.1136/bjsports-2016-097132] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To summarise all meta-analyses of randomised controlled trials that have evaluated the effects of exercise therapy on functional capacity in patients with chronic diseases. DESIGN Umbrella review of meta-analyses of randomised controlled trials. DATA SOURCES We systematically searched the CENTRAL, CINAHL, DARE, Medline, OTSeeker, PEDro, SPORTDiscus, ProQuest Nursing & Allied Health Database, Web of Science, Scopus, OpenGrey and BMC Proceedings from database inception to 1 September 2016. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included meta-analyses that compared the effects of exercise therapy with no treatment or usual care in adults with non-communicable chronic diseases and included outcomes related to functional capacity. We excluded meta-analyses with less than 100 patients. RESULTS Eighty-five meta-analyses with 22 different chronic diseases were included. The exercise interventions resulted in statistically significant (p<0.05) improvements for 126 of 146 (86%) functional capacity outcomes, compared with the control group. The standardised mean differences were small in 64 (44%), moderate in 54 (37%) and large in 28 (19%) of the 146 functional capacity outcomes. The results were similar for aerobic exercise, resistance training, and aerobic and resistance training combined. There were no significant differences in serious adverse effects between the intervention and control groups in any of the meta-analyses. CONCLUSION Exercise therapy appears to be a safe way to improve functional capacity and reduce disability in individuals with chronic disease.
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Affiliation(s)
- Tero Pasanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Samppa Tolvanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Ari Heinonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Bénéfices de l’activité physique pendant et après cancer : des connaissances scientifiques aux repères pratiques. ONCOLOGIE 2017. [DOI: 10.1007/s10269-017-2703-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cramer H, Lauche R, Klose P, Lange S, Langhorst J, Dobos GJ. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database Syst Rev 2017; 1:CD010802. [PMID: 28045199 PMCID: PMC6465041 DOI: 10.1002/14651858.cd010802.pub2] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Breast cancer is the cancer most frequently diagnosed in women worldwide. Even though survival rates are continually increasing, breast cancer is often associated with long-term psychological distress, chronic pain, fatigue and impaired quality of life. Yoga comprises advice for an ethical lifestyle, spiritual practice, physical activity, breathing exercises and meditation. It is a complementary therapy that is commonly recommended for breast cancer-related impairments and has been shown to improve physical and mental health in people with different cancer types. OBJECTIVES To assess effects of yoga on health-related quality of life, mental health and cancer-related symptoms among women with a diagnosis of breast cancer who are receiving active treatment or have completed treatment. SEARCH METHODS We searched the Cochrane Breast Cancer Specialised Register, MEDLINE (via PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), Indexing of Indian Medical Journals (IndMED), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal and Clinicaltrials.gov on 29 January 2016. We also searched reference lists of identified relevant trials or reviews, as well as conference proceedings of the International Congress on Complementary Medicine Research (ICCMR), the European Congress for Integrative Medicine (ECIM) and the American Society of Clinical Oncology (ASCO). We applied no language restrictions. SELECTION CRITERIA Randomised controlled trials were eligible when they (1) compared yoga interventions versus no therapy or versus any other active therapy in women with a diagnosis of non-metastatic or metastatic breast cancer, and (2) assessed at least one of the primary outcomes on patient-reported instruments, including health-related quality of life, depression, anxiety, fatigue or sleep disturbances. DATA COLLECTION AND ANALYSIS Two review authors independently collected data on methods and results. We expressed outcomes as standardised mean differences (SMDs) with 95% confidence intervals (CIs) and conducted random-effects model meta-analyses. We assessed potential risk of publication bias through visual analysis of funnel plot symmetry and heterogeneity between studies by using the Chi2 test and the I2 statistic. We conducted subgroup analyses for current treatment status, time since diagnosis, stage of cancer and type of yoga intervention. MAIN RESULTS We included 24 studies with a total of 2166 participants, 23 of which provided data for meta-analysis. Thirteen studies had low risk of selection bias, five studies reported adequate blinding of outcome assessment and 15 studies had low risk of attrition bias.Seventeen studies that compared yoga versus no therapy provided moderate-quality evidence showing that yoga improved health-related quality of life (pooled SMD 0.22, 95% CI 0.04 to 0.40; 10 studies, 675 participants), reduced fatigue (pooled SMD -0.48, 95% CI -0.75 to -0.20; 11 studies, 883 participants) and reduced sleep disturbances in the short term (pooled SMD -0.25, 95% CI -0.40 to -0.09; six studies, 657 participants). The funnel plot for health-related quality of life was asymmetrical, favouring no therapy, and the funnel plot for fatigue was roughly symmetrical. This hints at overall low risk of publication bias. Yoga did not appear to reduce depression (pooled SMD -0.13, 95% CI -0.31 to 0.05; seven studies, 496 participants; low-quality evidence) or anxiety (pooled SMD -0.53, 95% CI -1.10 to 0.04; six studies, 346 participants; very low-quality evidence) in the short term and had no medium-term effects on health-related quality of life (pooled SMD 0.10, 95% CI -0.23 to 0.42; two studies, 146 participants; low-quality evidence) or fatigue (pooled SMD -0.04, 95% CI -0.36 to 0.29; two studies, 146 participants; low-quality evidence). Investigators reported no serious adverse events.Four studies that compared yoga versus psychosocial/educational interventions provided moderate-quality evidence indicating that yoga can reduce depression (pooled SMD -2.29, 95% CI -3.97 to -0.61; four studies, 226 participants), anxiety (pooled SMD -2.21, 95% CI -3.90 to -0.52; three studies, 195 participants) and fatigue (pooled SMD -0.90, 95% CI -1.31 to -0.50; two studies, 106 participants) in the short term. Very low-quality evidence showed no short-term effects on health-related quality of life (pooled SMD 0.81, 95% CI -0.50 to 2.12; two studies, 153 participants) or sleep disturbances (pooled SMD -0.21, 95% CI -0.76 to 0.34; two studies, 119 participants). No trial adequately reported safety-related data.Three studies that compared yoga versus exercise presented very low-quality evidence showing no short-term effects on health-related quality of life (pooled SMD -0.04, 95% CI -0.30 to 0.23; three studies, 233 participants) or fatigue (pooled SMD -0.21, 95% CI -0.66 to 0.25; three studies, 233 participants); no trial provided safety-related data. AUTHORS' CONCLUSIONS Moderate-quality evidence supports the recommendation of yoga as a supportive intervention for improving health-related quality of life and reducing fatigue and sleep disturbances when compared with no therapy, as well as for reducing depression, anxiety and fatigue, when compared with psychosocial/educational interventions. Very low-quality evidence suggests that yoga might be as effective as other exercise interventions and might be used as an alternative to other exercise programmes.
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Affiliation(s)
- Holger Cramer
- University of Duisburg‐EssenDepartment of Internal and Integrative Medicine, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
| | - Romy Lauche
- University of Technology SydneyAustralian Research Centre in Complementary and Integrative Medicine235‐253 Jones StreetUltimoAustralia2007
| | - Petra Klose
- University of Duisburg‐EssenDepartment of Internal and Integrative Medicine, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
| | - Silke Lange
- University of Duisburg‐EssenDepartment of Internal and Integrative Medicine, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
| | - Jost Langhorst
- University of Duisburg‐EssenDepartment of Integrative Gastroenterology, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
| | - Gustav J Dobos
- University of Duisburg‐EssenDepartment of Internal and Integrative Medicine, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
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Igelström H, Berntsen S, Demmelmaier I, Johansson B, Nordin K. Exercise during and after curative oncological treatment – a mapping review. PHYSICAL THERAPY REVIEWS 2016. [DOI: 10.1080/10833196.2016.1262109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Helena Igelström
- Department of Public Health and Caring Sciences, Uppsala University , Uppsala, Sweden
| | - Sveinung Berntsen
- Department of Public Health and Caring Sciences, Uppsala University , Uppsala, Sweden
- Department of Public Health, Sport and Nutrition, University of Agder , Kristiansand, Norway
| | - Ingrid Demmelmaier
- Department of Public Health and Caring Sciences, Uppsala University , Uppsala, Sweden
| | - Birgitta Johansson
- Department of Public Health and Caring Sciences, Uppsala University , Uppsala, Sweden
- Department of Immunology, Genetics and Pathology, Uppsala University , Uppsala, Sweden
| | - Karin Nordin
- Department of Public Health and Caring Sciences, Uppsala University , Uppsala, Sweden
- Department of Public Health, Sport and Nutrition, University of Agder , Kristiansand, Norway
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Uhm KE, Yoo JS, Chung SH, Lee JD, Lee I, Kim JI, Lee SK, Nam SJ, Park YH, Lee JY, Hwang JH. Effects of exercise intervention in breast cancer patients: is mobile health (mHealth) with pedometer more effective than conventional program using brochure? Breast Cancer Res Treat 2016; 161:443-452. [PMID: 27933450 DOI: 10.1007/s10549-016-4065-8] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 11/22/2016] [Indexed: 01/10/2023]
Affiliation(s)
- Kyeong Eun Uhm
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Ilwon-ro, Gangnam-gu, Seoul, 06351, Korea
- Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Ji Sung Yoo
- Department of Rehabilitation Medicine, National Cancer Center, Gyeonggi-do, Korea
| | - Seung Hyun Chung
- Department of Rehabilitation Medicine, National Cancer Center, Gyeonggi-do, Korea
| | - Jong Doo Lee
- Institute for Integrative Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
| | - Ilkyun Lee
- Institute for Integrative Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
- Department of Surgery, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
| | - Joong Il Kim
- Institute for Integrative Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
| | - Se Kyung Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong Hyun Park
- Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Korea
| | - Ji Youl Lee
- Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Korea.
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Ilwon-ro, Gangnam-gu, Seoul, 06351, Korea.
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Zhu G, Zhang X, Wang Y, Xiong H, Zhao Y, Sun F. Effects of exercise intervention in breast cancer survivors: a meta-analysis of 33 randomized controlled trails. Onco Targets Ther 2016; 9:2153-68. [PMID: 27110131 PMCID: PMC4835133 DOI: 10.2147/ott.s97864] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background Exercise is associated with favorable outcomes in cancer survivors. The purpose of this meta-analysis is to comprehensively summarize the effects of exercise intervention in breast cancer survivors. Methods A systematic search of PubMed, Elsevier, and Google scholar was conducted up to March 2015. References from relevant meta-analyses and reviews were also checked. Results Thirty-three randomized controlled trials were included in this meta-analysis, including 2,659 breast cancer survivors. Compared with the control group, quality of life was significantly improved in exercise intervention group, especially in mental health and general health subscales of short form 36 questionnaire, as well as emotion well-being and social well-being subscales of the Functional Assessment of Cancer Therapy. Besides, exercise alleviated the symptoms of depression and anxiety in the exercise group. Furthermore, exercise was also associated with positive outcomes in body mass index, lean mass, and muscle strength. In addition, the serum concentration of insulin, insulin-like growth factor-II, and insulin-like growth factor binding protein-1 was significantly reduced in exercise intervention group. However, based on the current data of this meta-analysis, there were no significant differences in sleep dysfunction or fatigue between groups. Conclusion Our study suggested that exercise intervention was beneficial to breast cancer survivors. Therefore, exercise should be recommended to this patient group.
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Affiliation(s)
- Guoqing Zhu
- Department of Clinical Laboratory Medicine, Shanghai Tenth People's Hospital of Tongji University, Shanghai, People's Republic of China
| | - Xiao Zhang
- Department of Clinical Laboratory Medicine, Shanghai Tenth People's Hospital of Tongji University, Shanghai, People's Republic of China
| | - Yulan Wang
- Department of Clinical Laboratory Medicine, Shanghai Tenth People's Hospital of Tongji University, Shanghai, People's Republic of China
| | - Huizi Xiong
- Department of Dermatology, Shanghai Tenth People's Hospital of Tongji University, Shanghai, People's Republic of China
| | - Yinghui Zhao
- Department of Clinical Laboratory Medicine, Shanghai Tenth People's Hospital of Tongji University, Shanghai, People's Republic of China
| | - Fenyong Sun
- Department of Clinical Laboratory Medicine, Shanghai Tenth People's Hospital of Tongji University, Shanghai, People's Republic of China
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Higher-intensity exercise helps cancer survivors remain motivated. J Cancer Surviv 2015; 10:524-33. [PMID: 26586495 DOI: 10.1007/s11764-015-0498-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 11/05/2015] [Indexed: 12/22/2022]
Abstract
PURPOSE The aim of the present study was to determine if exercise intensity impacts upon the psychosocial responses of breast and prostate cancer survivors to a rehabilitation program. METHODS Eighty-seven prostate and 72 breast cancer survivors participated in an 8-week exercise and supportive group psychotherapy intervention (n = 84) or control (n = 75) group. Intervention participants were randomized to low-to-moderate intensity exercise (LIG; n = 44; 60-65 % VO2peak, 50-65 % one repetition maximum (1RM)) or moderate-to-high intensity exercise (HIG; n = 40; 75-80 % VO2peak, 65-80 % 1RM) while controls continued usual care. Before and after the 8 weeks, all participants completed the Functional Assessment of Cancer Therapy-Breast or -Prostate to assess quality of life (QOL) and Behavioural Regulations of Exercise Version 2 for exercise motivation. Intervention participants also completed a follow-up assessment 4 months post-intervention. RESULTS All three groups improved in QOL from baseline to post-intervention, with no significant differences. From post-intervention to follow-up, the LIG and HIG similarly maintained QOL scores. Between baseline and post-intervention, both intervention arms improved their motivation to exercise compared to the controls (p = 0.004). At the 4-month follow-up, the HIG had maintained their overall exercise motivation (p < 0.001) and both domains of intrinsic motivation (identified regulation, p = 0.047; intrinsic regulation, p = 0.007); however, the LIG had regressed. CONCLUSIONS The structured intervention was successful at improving autonomous exercise motivation, regardless of exercise intensity. However, only those participants who had exercised at a higher intensity sustained their improvement. Intervention participation did not improve QOL more than controls. IMPLICATIONS FOR CANCER SURVIVORS Higher-intensity exercise is more likely to result in more sustainable increases in motivation to exercise among cancer survivors.
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Dieli-Conwright CM, Orozco BZ. Exercise after breast cancer treatment: current perspectives. BREAST CANCER-TARGETS AND THERAPY 2015; 7:353-62. [PMID: 26543382 PMCID: PMC4622557 DOI: 10.2147/bctt.s82039] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Over the past 2 decades, great strides have been made in the field of exercise-oncology research, particularly with breast cancer. This area of research is particularly important since there are >2.8 million breast cancer survivors who are in need of an intervention that can offset treatment-related side effects. Noticeable reductions in physical fitness (ie, cardiopulmonary fitness and muscular strength), negative changes in body composition (ie, increase in body mass, decrease in lean body mass, and increase in fat mass), increased fatigue, depression, or anxiety are some of the common side effects of cancer treatments that negatively impact overall quality of life and increase the risk for the development of comorbidities. Exercise plays a vital role in improving cardiopulmonary function, psychological events, muscular strength, and endurance in breast cancer survivors, and thus should be considered as a key factor of lifestyle intervention to reverse negative treatment-related side effects. The purpose of this review is to address current perspectives on the benefits of aerobic and resistance exercise after breast cancer treatments. This review is focused on the well-established benefits of exercise on physical and emotional well-being, bone health, lymphedema management, and the postulated benefits of exercise on risk reduction for recurrence of breast cancer.
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Affiliation(s)
- Christina M Dieli-Conwright
- Division of Biokinesiology and Physical Therapy, Women's Health and Exercise Laboratory, University of Southern California, Los Angeles, CA, USA
| | - Breanna Z Orozco
- Division of Biokinesiology and Physical Therapy, Women's Health and Exercise Laboratory, University of Southern California, Los Angeles, CA, USA
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The effect of a community-based exercise intervention on symptoms and quality of life. Cancer Nurs 2015; 37:E43-50. [PMID: 23519041 DOI: 10.1097/ncc.0b013e318288d40e] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Moderate-intensity physical activity in women with breast cancer has been reported to improve physical and psychological outcomes. However, initiation and adherence to a routine physical activity program for cancer survivors after therapy may be challenging. OBJECTIVE The purpose of this study was to determine the feasibility and effect of a community-based exercise intervention on physical and psychological symptoms and quality of life in breast cancer survivors. METHODS A 1-group pretest-posttest design was used to evaluate a thrice weekly, 4- to 6-month supervised exercise intervention on symptoms and quality of life. Data were collected at baseline and end of the intervention, using the Breast Cancer Prevention Trial Checklist, the Symptom Distress Scale, the Centers for Epidemiology Scale for Depression, and the Medical Outcomes Short Form. RESULTS There were 26 participants, with a mean (SD) age of 51.3 (6.2) years; most were married, well educated, and employed. The intervention was delivered at 3 community fitness centers, and adherence ranged from 75% to 98%. Vasomotor, musculoskeletal, and cognitive symptoms were common, but only muscle stiffness, fatigue, and depression significantly changed over time (P = .04, .05, and .01, respectively). Quality of life improved significantly in the areas of physical, emotional, and social function; pain; vitality; and mental health. CONCLUSIONS Providing an exercise intervention in the community where women live and work is feasible and improves physical, psychological, and functional well-being. IMPLICATIONS FOR PRACTICE Exercise is a key component of cancer rehabilitation and needs to be integrated into our standard care.
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Klassen O, Schmidt ME, Scharhag-Rosenberger F, Sorkin M, Ulrich CM, Schneeweiss A, Potthoff K, Steindorf K, Wiskemann J. Cardiorespiratory fitness in breast cancer patients undergoing adjuvant therapy. Acta Oncol 2014; 53:1356-65. [PMID: 24837860 DOI: 10.3109/0284186x.2014.899435] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE The aim of this work was to investigate cardiorespiratory fitness in breast cancer patients at different time points of anti-cancer treatment. PATIENTS AND METHODS Non-metastatic breast cancer patients (n = 222, mean age 55 years) were categorized into four subgroups according to their treatment status. Cardiopulmonary exercise testing (CPET) was used to measure patients' cardiorespiratory fitness, including oxygen delivery and metabolic muscle function. Testing was performed by bicycle ergometry, and maximal oxygen uptake (VO2peak) was measured. Heart rate during exercise at 50 watts (HR50) was assessed as a cardiocirculatory parameter and ventilatory threshold (VT) was used as an indicator of the O2 supply to muscle. Analysis of covariance was used to estimate the impact of different cancer treatments on cardiorespiratory fitness with adjustment for clinical factors. RESULTS Submaximal measures were successfully assessed in 220 (99%) and 200 (90%) patients for HR50 and VT, while criteria for maximal exercise testing were met by 176 patients (79%), respectively. The mean VO2peak was 20.6 ± 6.7 ml/kg/min, mean VT 10.7 ± 2.9 ml/min/kg and mean HR50 112 ± 16 beats/min. Chemotherapy was significantly associated with decreased VO2peak, with significantly lower adjusted mean VO2peak among patients post adjuvant chemotherapy compared to patients with no chemotherapy or those who just started chemotherapy regime (all p < 0.01). Patients post adjuvant chemotherapy reached only 63% of the VO2peak level expected for their age- and BMI-category (mean VO2peak 15.5 ± 4.8 ml/kg/min). Similarly, HR50 was significantly associated with treatment. However, VT was not associated with treatment. CONCLUSION Breast cancer patients have marked and significantly impaired cardiopulmonary function during and after chemotherapy. Hereby, chemotherapy appears to impair cardiorespiratory fitness by influencing the oxygen delivery system rather than impacting metabolic muscle function. Our findings underline the need of exercise training in breast cancer patients to counteract the loss of cardiorespiratory fitness during the anti-cancer treatment.
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Affiliation(s)
- Oliver Klassen
- Preventive Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ) , Heidelberg , Germany
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Makari-Judson G, Braun B, Jerry DJ, Mertens WC. Weight gain following breast cancer diagnosis: Implication and proposed mechanisms. World J Clin Oncol 2014; 5:272-282. [PMID: 25114844 PMCID: PMC4127600 DOI: 10.5306/wjco.v5.i3.272] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Revised: 03/27/2014] [Accepted: 06/20/2014] [Indexed: 02/06/2023] Open
Abstract
Weight gain occurs in the majority of women following breast cancer treatment. An overview of studies describing weight gain amongst women treated with early to modern chemotherapy regimens is included. Populations at higher risk include women who are younger, closer to ideal body weight and who have been treated with chemotherapy. Weight gain ranges between 1 to 5 kg, and may be associated with change in body composition with gain in fat mass and loss in lean body mass. Women are unlikely to return to pre-diagnosis weight. Possible mechanisms including inactivity and metabolic changes are explored. Potential interventions are reviewed including exercise, dietary changes and pharmacologic agents. Although breast cancer prognosis does not appear to be significantly impacted, weight gain has negative consequences on quality of life and overall health. Future studies should explore change in body composition, metabolism and insulin resistance. Avoiding weight gain in breast cancer survivors following initial diagnosis and treatment should be encouraged.
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Hung YC, Bauer JD, Horsely P, Coll J, Bashford J, Isenring EA. Telephone-delivered nutrition and exercise counselling after auto-SCT: a pilot, randomised controlled trial. Bone Marrow Transplant 2014; 49:786-92. [PMID: 24710562 DOI: 10.1038/bmt.2014.52] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 01/24/2014] [Accepted: 01/29/2014] [Indexed: 01/11/2023]
Abstract
Adverse changes in nutrition-related outcomes including quality of life (QoL) occur after PBSC transplantation. This randomised controlled trial aims to evaluate the impact of nutrition and exercise counselling provided at hospital discharge on nutritional status, body composition and QoL post transplantation. Usual care (UC) (n=19) received no intervention after discharge; extended care (EC) (n=18) received fortnightly telephone counselling from a dietitian and exercise physiologist up to 100 days post transplantation. Nutritional status (patient-generated subjective global assessment, and diet history), QoL (EORTC QLQ-C30 version 3) and body composition (air displacement plethysmography) were assessed at pre-admission, discharge and 100 days post transplantation. Intervention groups were compared using two-sample t-tests of changes in the outcomes; results were adjusted using analysis of covariance. EC exhibited clinically important but not statistically significant increases in protein intake (14.7 g; confidence interval (CI) 95% -6.5, 35.9, P=0.165), cognitive functioning (7.2; CI 95% -7.9, 22.2, P=0.337) and social functioning (16.5; CI 95% -7.3, 40.3, P=0.165) compared with UC. Relative to pre-admission, EC experienced less weight loss than UC (-3.3 kg; CI 95% -6.7, 0.2, P=0.062). Physical activity was not significantly different between the groups. Ongoing nutrition and exercise counselling may prevent further weight loss and improve dietary intake and certain QoL components in autologous PBSC transplantation patients following hospitalisation.
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Affiliation(s)
- Y-C Hung
- Centre for Dietetics Research, School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia
| | - J D Bauer
- 1] Centre for Dietetics Research, School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia [2] The Wesley Research Institute, Brisbane, Queensland, Australia
| | - P Horsely
- The Wesley Research Institute, Brisbane, Queensland, Australia
| | - J Coll
- The Wesley Research Institute, Brisbane, Queensland, Australia
| | - J Bashford
- Haematology & Oncology Clinics of Australia, The Wesley Medical Centre, Brisbane, Queensland, Australia
| | - E A Isenring
- 1] Centre for Dietetics Research, School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia [2] Department of Nutrition & Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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Zeng Y, Huang M, Cheng ASK, Zhou Y, So WKW. Meta-analysis of the effects of exercise intervention on quality of life in breast cancer survivors. Breast Cancer 2014; 21:262-74. [PMID: 24569944 DOI: 10.1007/s12282-014-0521-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 02/03/2014] [Indexed: 11/28/2022]
Abstract
Breast cancer is the most common type of cancer among women worldwide. Diagnosis and treatment of breast cancer pose an array of physical and psychological threats to the survivors. Exercise interventions may be particularly appropriate for cancer survivors because they have the potential to improve physical and psychological functioning. The review aims to examine the effectiveness of exercise intervention on the quality of life (QOL) of breast cancer survivors. Five databases (Medline, CINAHL, Scopus, The Cochrane Library, and CAJ Full-text Database) were searched from 2003 to July 2013. Clinical controlled trials of exercise interventions for breast cancer survivors who were at least 18 years old and had completed active cancer treatment were included. A total of 25 trials were included in this study, of which 19 were pooled together statistically. Subjects in the exercise interventions had higher overall QOL than subjects in the control group. The standardized mean difference (SMD) for changes in overall general QOL scores was 0.70 (95 % CI 0.21, 1.19). The SMD for changes in cancer-specific QOL scores was 0.38 (95 % CI 0.03, 0.74). For cancer-specific QOL domains, there were positive but non-significant trends in two QOL domains (breast symptoms: Z score = 1.12, p = 0.26; arm symptoms: Z score = 1.32, p = 0.19). This study provides updated findings supporting the idea that exercise interventions have statistically significant effects on overall QOL in breast cancer survivors, as well as positive trends for cancer site-specific QOL domains (breast and arm symptoms).
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Affiliation(s)
- Yingchun Zeng
- Department of Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,
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Brown JC, Winters-Stone K, Lee A, Schmitz KH. Cancer, physical activity, and exercise. Compr Physiol 2013; 2:2775-809. [PMID: 23720265 DOI: 10.1002/cphy.c120005] [Citation(s) in RCA: 197] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This review examines the relationship between physical activity and cancer along the cancer continuum, and serves as a synthesis of systematic and meta-analytic reviews conducted to date. There exists a large body of epidemiologic evidence that conclude those who participate in higher levels of physical activity have a reduced likelihood of developing a variety of cancers compared to those who engage in lower levels of physical activity. Despite this observational evidence, the causal pathway underlying the association between participation in physical activity and cancer risk reduction remains unclear. Physical activity is also a useful adjunct to improve the deleterious sequelae experienced during cancer treatment. These deleterious sequelae may include fatigue, muscular weakness, deteriorated functional capacity, and many others. The benefits of physical activity during cancer treatment are similar to those experienced after treatment. Despite the growing volume of literature examining physical activity and cancer across the cancer continuum, a number of research gaps exist. There is little evidence on the safety of physical activity among all cancer survivors, as most trials have selectively recruited participants. The specific dose of exercise needed to optimize primary cancer prevention or symptom control during and after cancer treatment remains to be elucidated.
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Affiliation(s)
- Justin C Brown
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Cramer H, Lauche R, Klose P, Lange S, Langhorst J, Dobos GJ. Yoga for women diagnosed with breast cancer. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2013. [DOI: 10.1002/14651858.cd010802] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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41
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Conn VS. Comparative Effectiveness Research. West J Nurs Res 2013; 35:679-82. [DOI: 10.1177/0193945913481440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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42
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Moonsammy SH, Guglietti CL, Santa Mina D, Ferguson S, Kuk JL, Urowitz S, Wiljer D, Ritvo P. A pilot study of an exercise & cognitive behavioral therapy intervention for epithelial ovarian cancer patients. J Ovarian Res 2013; 6:21. [PMID: 23557323 PMCID: PMC3623735 DOI: 10.1186/1757-2215-6-21] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 03/24/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ovarian cancer has the highest mortality rate of all gynaecologic cancers. Faced with poor prognoses, stressful treatment effects and a high likelihood of recurrence, survivors must confront significant physical and psychological morbidities that negatively impact health-related quality of life. Frequently reported side effects include cancer-related fatigue, peripheral neuropathy, and psychological distress. Exercise and cognitive behavioral therapy interventions have counteracted such adverse effects in other cancer populations. OBJECTIVE To investigate the feasibility and benefits of a 24-week home-based exercise intervention, coordinated with 12 weeks of cognitive behavioral therapy (two sessions per month), developed for two types of patients diagnosed with epithelial ovarian cancer: 1) those undergoing primary treatment with adjuvant chemotherapy after primary surgery; 2) those on surveillance after completing treatment within the last 2 years. METHODS Participants were recruited from the Gynaecologic Oncology Clinic. Eligible participants completed baseline assessments and were provided with home-based exercise equipment. Cognitive behavioral therapy was provided every other week for patients via telephone. Assessments were completed at baseline (T1), 3 months (T2) and 6 months (T3). RESULTS 19 of the 46 eligible patients approached were enrolled, with 7 patients in the treatment group and 12 in the surveillance group. There was a significant within group increase in peak VO2 from baseline to 6 months: F(2,16) = 5.531, p = 0.015, partial η2 = 0.409. CONCLUSION The combined 6-month exercise-cognitive behavioral therapy intervention was associated with significant increases in aerobic fitness in epithelial ovarian cancer patients assessed. These improvements were similar regardless of whether the patient was receiving chemotherapy or under surveillance.
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Affiliation(s)
- Shalini H Moonsammy
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.
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Fernandes AFC, Vidal GO, Moreira CB, Silva TBDCE, Valentim PNR, Santos MCL. Lymphedema in the Mastectomy Postoperative Period: An Integrative Literature Review. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/abcr.2013.24025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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44
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Move more for life: the protocol for a randomised efficacy trial of a tailored-print physical activity intervention for post-treatment breast cancer survivors. BMC Cancer 2012. [PMID: 22569139 DOI: 10.1186/1471‐2407‐12‐172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to early detection and advances in treatment, the number of women surviving breast cancer is increasing. Whilst there are many positive aspects of improved survival, breast cancer survival is associated with many long-term health and psychosocial sequelae. Engaging in regular physical activity post-diagnosis can reduce this burden. Despite this evidence, the majority of breast cancer survivors do not engage in regular physical activity. The challenge is to provide breast cancer survivors with appealing and effective physical activity support in a sustainable and cost-effective way. This article describes the protocol for the Move More for Life Study, which aims to assess the relative efficacy of two promising theory-based, print interventions designed to promote regular physical activity amongst breast cancer survivors. METHOD AND DESIGN Breast cancer survivors were recruited from across Australia. Participants will be randomised into one of three groups: (1) A tailored-print intervention group, (2) a targeted-print intervention group, or (3) a standard recommendation control group. Participants in the tailored-print intervention group will receive 3 tailored newsletters in the mail over a three month period. Participants in the targeted-print group will receive a previously developed physical activity guidebook designed specifically for breast cancer survivors immediately after baseline. Participants in the standard recommendation control will receive a brochure detailing the physical activity guidelines for Australian adults. All participants will be assessed at baseline, and at 4 and 10 months post-baseline. Intervention efficacy for changing the primary outcomes (mins/wk aerobic physical activity; sessions/exercises per week resistance physical activity) and secondary outcomes (steps per day, health-related quality life, compliance with physical activity guidelines, fatigue) will be assessed. Mediation and moderation analyses will also be conducted. DISCUSSION Given the growing number of cancer survivors, distance-based behaviour change programs addressing physical activity have the potential to make a significant public health impact. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) identifier: ACTRN12611001061921.
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Short CE, James EL, Girgis A, Mcelduff P, Plotnikoff RC. Move more for life: the protocol for a randomised efficacy trial of a tailored-print physical activity intervention for post-treatment breast cancer survivors. BMC Cancer 2012; 12:172. [PMID: 22569139 PMCID: PMC3518246 DOI: 10.1186/1471-2407-12-172] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 04/14/2012] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Due to early detection and advances in treatment, the number of women surviving breast cancer is increasing. Whilst there are many positive aspects of improved survival, breast cancer survival is associated with many long-term health and psychosocial sequelae. Engaging in regular physical activity post-diagnosis can reduce this burden. Despite this evidence, the majority of breast cancer survivors do not engage in regular physical activity. The challenge is to provide breast cancer survivors with appealing and effective physical activity support in a sustainable and cost-effective way. This article describes the protocol for the Move More for Life Study, which aims to assess the relative efficacy of two promising theory-based, print interventions designed to promote regular physical activity amongst breast cancer survivors. METHOD AND DESIGN Breast cancer survivors were recruited from across Australia. Participants will be randomised into one of three groups: (1) A tailored-print intervention group, (2) a targeted-print intervention group, or (3) a standard recommendation control group. Participants in the tailored-print intervention group will receive 3 tailored newsletters in the mail over a three month period. Participants in the targeted-print group will receive a previously developed physical activity guidebook designed specifically for breast cancer survivors immediately after baseline. Participants in the standard recommendation control will receive a brochure detailing the physical activity guidelines for Australian adults. All participants will be assessed at baseline, and at 4 and 10 months post-baseline. Intervention efficacy for changing the primary outcomes (mins/wk aerobic physical activity; sessions/exercises per week resistance physical activity) and secondary outcomes (steps per day, health-related quality life, compliance with physical activity guidelines, fatigue) will be assessed. Mediation and moderation analyses will also be conducted. DISCUSSION Given the growing number of cancer survivors, distance-based behaviour change programs addressing physical activity have the potential to make a significant public health impact. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) identifier: ACTRN12611001061921.
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Affiliation(s)
- Camille E Short
- School of Medicine and Public Health, Priority Research Centre for Health Behaviour, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Erica L James
- School of Medicine and Public Health, Priority Research Centre for Health Behaviour, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Afaf Girgis
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Patrick Mcelduff
- Clinical Trials Unit, Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Ronald C Plotnikoff
- School of Education, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
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Fong DYT, Ho JWC, Hui BPH, Lee AM, Macfarlane DJ, Leung SSK, Cerin E, Chan WYY, Leung IPF, Lam SHS, Taylor AJ, Cheng KK. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ 2012; 344:e70. [PMID: 22294757 PMCID: PMC3269661 DOI: 10.1136/bmj.e70] [Citation(s) in RCA: 525] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To systematically evaluate the effects of physical activity in adult patients after completion of main treatment related to cancer. DESIGN Meta-analysis of randomised controlled trials with data extraction and quality assessment performed independently by two researchers. DATA SOURCES Pubmed, CINAHL, and Google Scholar from the earliest possible year to September 2011. References from meta-analyses and reviews. STUDY SELECTION Randomised controlled trials that assessed the effects of physical activity in adults who had completed their main cancer treatment, except hormonal treatment. RESULTS There were 34 randomised controlled trials, of which 22 (65%) focused on patients with breast cancer, and 48 outcomes in our meta-analysis. Twenty two studies assessed aerobic exercise, and four also included resistance or strength training. The median duration of physical activity was 13 weeks (range 3-60 weeks). Most control groups were considered sedentary or were assigned no exercise. Based on studies on patients with breast cancer, physical activity was associated with improvements in insulin-like growth factor-I, bench press, leg press, fatigue, depression, and quality of life. When we combined studies on different types of cancer, we found significant improvements in body mass index (BMI), body weight, peak oxygen consumption, peak power output, distance walked in six minutes, right handgrip strength, and quality of life. Sources of study heterogeneity included age, study quality, study size, and type and duration of physical activity. Publication bias did not alter our conclusions. CONCLUSIONS Physical activity has positive effects on physiology, body composition, physical functions, psychological outcomes, and quality of life in patients after treatment for breast cancer. When patients with cancer other than breast cancer were also included, physical activity was associated with reduced BMI and body weight, increased peak oxygen consumption and peak power output, and improved quality of life.
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Affiliation(s)
- Daniel Y T Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, China
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Knobf MT, Coviello J. Lifestyle interventions for cardiovascular risk reduction in women with breast cancer. Curr Cardiol Rev 2011; 7:250-7. [PMID: 22758626 PMCID: PMC3322443 DOI: 10.2174/157340311799960627] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Revised: 09/16/2011] [Accepted: 11/27/2011] [Indexed: 01/24/2023] Open
Abstract
PURPOSE The purpose of this paper is to identify risk factors for cardiovascular disease in women with breast cancer and review healthy lifestyle behaviors as essential risk reduction strategies. FINDINGS Women with breast cancer account for 22% of the 12 million cancer survivors. Women diagnosed with breast cancer often present with modifiable and non-modifiable cardiovascular risk factors and/or pre-existing co-morbid illness. Any one or a combination of these factors may increase the risk of cardiovascular disease. There is strong evidence that healthy eating and routine physical activity can reduce cardiovascular disease. Exercise improves cardiovascular fitness, body composition and quality of life in breast cancer survivors and observational studies suggest a survival benefit. CLINICAL IMPLICATIONS Lifestyle interventions including a healthy diet, regular physical activity, weight management and smoking cessation should be integrated into a survivorship care plan to reduce cardiovascular disease risk and promote better health for women with breast cancer.
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Affiliation(s)
- M Tish Knobf
- Yale University School of Nursing, 100 Church Street South, New Haven, CT 06536-0740, USA.
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48
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Loprinzi PD, Cardinal BJ. Effects of physical activity on common side effects of breast cancer treatment. Breast Cancer 2011; 19:4-10. [PMID: 21725654 DOI: 10.1007/s12282-011-0292-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 06/14/2011] [Indexed: 01/27/2023]
Abstract
Motivating women with breast cancer to engage in regular physical activity may be an enormous challenge given the common side effects of breast cancer treatment. The objective of this narrative review is to briefly summarize recent research evidence examining the influence of physical activity on commonly occurring side effects of breast cancer treatment. Overall, current research evidence indicates that regular participation in physical activity after breast cancer diagnosis may mitigate common side effects of breast cancer adjuvant therapy, including fatigue, depression, impaired quality of life, decreased muscular strength, decreased aerobic capacity, and weight gain. Future research could examine the influence that physical activity has on the effectiveness of breast cancer treatment. Implications for health care professionals are discussed.
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Affiliation(s)
- Paul D Loprinzi
- Department of Exercise Science, Bellarmine University, Louisville 40205, KY, USA.
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Greß S, Kiselev J, Mohokum M, Kuss K, Wagensveld AV. Die Rolle der Physiotherapie bei der Versorgung chronischer Erkrankungen. Internationale Erfahrungen und nationale Defizite. ACTA ACUST UNITED AC 2011. [DOI: 10.3790/sfo.60.7.151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Effects of a 6-Week Walking Program on Taiwanese Women Newly Diagnosed With Early-Stage Breast Cancer. Cancer Nurs 2011; 34:E1-13. [PMID: 20697267 DOI: 10.1097/ncc.0b013e3181e4588d] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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