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Low SLK, Ho GF, Liu B, Koh ES, Fei Y, Teo CS, Zhu X. Exploring Guolin Qigong (Mind-Body Exercise) for Improving Cancer Related Fatigue in Cancer Survivors: A Mixed Method Randomized Controlled Trial Protocol. Integr Cancer Ther 2024; 23:15347354241252698. [PMID: 38757745 PMCID: PMC11102686 DOI: 10.1177/15347354241252698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 04/05/2024] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Cancer-related fatigue and its associated symptoms of sleep disorder and depression are prevalent in cancer survivors especially among breast, lung, and colorectal cancer survivors. While there is no gold standard for treating cancer-related fatigue currently, studies of mind-body exercises such as Qigong have reported promise in reducing symptoms. This study was designed to evaluate the feasibility and effect of Guolin Qigong on cancer-related fatigue and other symptoms in breast, lung and colorectal cancer survivors while exploring their perceptions and experiences of Guolin Qigong intervention. METHODS This is an open-label randomized controlled trial with 60 participants divided into 2 study groups in a 1:1 ratio. The intervention group will receive 12 weeks of Guolin Qigong intervention with a 4-week follow-up while control will receive usual care under waitlist. The primary outcome will be feasibility measured based on recruitment and retention rates, class attendance, home practice adherence, nature, and quantum of missing data as well as safety. The secondary subjective outcomes of fatigue, sleep quality and depression will be measured at Week-1 (baseline), Week-6 (mid-intervention), Week-12 (post-intervention), and Week-16 (4 weeks post-intervention) while an objective 24-hour urine cortisol will be measured at Week-1 (baseline) and Week-12 (post-intervention). We will conduct a semi-structured interview individually with participants within 3 months after Week-16 (4 weeks post-intervention) to obtain a more comprehensive view of practice adherence. DISCUSSION This is the first mixed-method study to investigate the feasibility and effect of Guolin Qigong on breast, lung, and colorectal cancer survivors to provide a comprehensive understanding of Guolin Qigong's intervention impact and participants' perspectives. The interdisciplinary collaboration between Western Medicine and Chinese Medicine expertise of this study ensures robust study design, enhanced participant care, rigorous data analysis, and meaningful interpretation of results. This innovative research contributes to the field of oncology and may guide future evidence-based mind-body interventions to improve cancer survivorship. TRIAL REGISTRATION This study has been registered with ANZCTR (ACTRN12622000688785p), was approved by Medical Research Ethic Committee of University Malaya Medical Centre (MREC ID NO: 2022323-11092) and recognized by Western Sydney University Human Research Ethics Committee (RH15124).
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Affiliation(s)
- Sara L. K. Low
- Western Sydney University, Penrith South, NSW, Australia
| | - Gwo Fuang Ho
- University Malaya Medical Centre, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | | | - Eng-Siew Koh
- University of New South Wales, Liverpool, NSW, Australia
| | - Yutong Fei
- Beijing University of Chinese Medicine, Beijing, China
| | | | - Xiaoshu Zhu
- Western Sydney University, Penrith South, NSW, Australia
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2
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Zhu GC, Chen KM, Belcastro F. Effects of Different Mind-body Exercises in Managing Chronic Pain of Older Adults: A Network Meta-analysis of Randomized Trials. Geriatr Nurs 2024; 55:183-190. [PMID: 38007907 DOI: 10.1016/j.gerinurse.2023.11.009] [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: 09/06/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 11/28/2023]
Abstract
INTRODUCTION Mind-body exercises (MBEs) were shown to be effective in managing chronic pain among older adults in several recent studies. However, the differences in the effects of different MBEs remained unclear. OBJECTIVE To compare the effects of different MBEs in managing chronic pain in older adults. METHODS Eight databases were searched for studies published between 2012 and 2023, and 14 studies were included in this systematic review and network meta-analysis (NMA). The NMA was performed using R and Metainsight. RESULTS Results showed that tai chi and yoga were effective in alleviating chronic pain, but their effects were not superior to traditional physical exercises and other MBEs. In addition, none of the MBEs were shown to be effective in mitigating chronic pain-related disabilities. CONCLUSION Tai chi and yoga can be used for relieving chronic pain in older adults; however, MBE programs alone were not sufficient to mitigate chronic pain-related disabilities.
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Affiliation(s)
- Guan-Cheng Zhu
- PhD, Postdoctoral Fellow; Center for Long-Term Care Research, Kaohsiung Medical University; 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, Taiwan 80708; Tel: 886-7-3121101.
| | - Kuei-Min Chen
- PhD, RN, FAAN, Professor; College of Nursing, Kaohsiung Medical University; 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, Taiwan 80708; Center for Long-Term Care Research, Kaohsiung Medical University; Department of Medical Research, Kaohsiung Medical University Hospital.
| | - Frank Belcastro
- PhD, Professor; Department of Education and Psychology, University of Dubuque; 2000 University Ave., Dubuque, Iowa 52001, USA.
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Physical Activity Influences Cortisol and Dehydroepiandrosterone (Sulfate) Levels in Older Adults: A Systematic Review and Meta-Analysis. J Aging Phys Act 2022; 31:330-351. [PMID: 35981715 DOI: 10.1123/japa.2021-0501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 06/18/2022] [Accepted: 06/24/2022] [Indexed: 11/18/2022]
Abstract
Age-related changes affect the ratio between two steroid hormones of the hypothalamic-pituitary-adrenal axis, cortisol and dehydroepiandrosterone (sulfate) (DHEA[S]). Physical activity (PA) may buffer the effects of chronic stress and counteract the aging decline of DHEA(S). Therefore, a systematic review was conducted to understand how PA influences physiological markers of cortisol and/or DHEA(S) and whether there is a difference in observational associations or experimental effects in older adults aged 65 years and older. A narrative synthesis was performed on nine observational studies, and meta-analyses were performed on 22 randomized controlled trials. There was low- to moderate-quality evidence that regular PA beneficially reduces cortisol and increases DHEA(S) levels. Subgroup analyses showed no clinically important differences between men and women, different exercise modalities, or health states. The findings cautiously suggest that regular PA of older adults' own choice that they find enjoyable could be recommended to improve cortisol and/or DHEA(S) levels.
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Gomaa S, West C, Lopez AM, Zhan T, Schnoll M, Abu-Khalaf M, Newberg A, Wen KY. A Telehealth-Delivered Tai Chi Intervention (TaiChi4Joint) for Managing Aromatase Inhibitor–Induced Arthralgia in Patients With Breast Cancer During COVID-19: Longitudinal Pilot Study. JMIR Form Res 2022; 6:e34995. [PMID: 35727609 PMCID: PMC9257610 DOI: 10.2196/34995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/22/2022] [Accepted: 05/16/2022] [Indexed: 12/19/2022] Open
Abstract
Background Estrogen receptor–positive breast cancer is the most common type of breast cancer in postmenopausal women. Aromatase inhibitors (AIs) are the endocrine therapy of choice recommended for these patients. Up to 50% of those treated with an AI develop arthralgia, often resulting in poor adherence and decreased quality of life. Objective The study is a single-arm longitudinal pilot study aiming to evaluate the safety, feasibility, acceptability, and potential efficacy of TaiChi4Joint, a remotely delivered 12-week tai chi intervention designed to relieve AI-induced joint pain. Methods Women diagnosed with stage 0-III breast cancer who received an AI for at least 2 months and reported arthralgia with a ≥4 score on a 0 to 10 scale for joint pain were eligible for study enrollment. Participants were encouraged to join tai chi classes delivered over Zoom three times a week for 12 weeks. Program engagement strategies included using a private Facebook study group and a Box cloud for archiving live class recordings. The program uses SMS text messaging and emails with periodic positive quotes and evidence-based information on tai chi for facilitating community bonding and class attendance. Participants were invited to complete the following assessments at baseline and at 1-, 2-, and 3-month intervals from study enrollment: Brief Pain Inventory, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), The Australian Canadian Osteoarthritis Hand Index (AUSCAN), Fatigue Symptom Inventory, Hot Flash Related Daily Interference Scale (HFRDIS), Pittsburgh Sleep Quality Index (PSQI), and Center for Epidemiological Studies–Depression (CES-D). Results A total of 55 eligible patients were invited to participate, and 39 (71%) consented and completed the baseline assessments. Participants attended 61% (median) of the suggested classes, with no tai chi–related adverse events reported. Of the 39 participants, 22 completed the 3-month follow-up assessment with a 56% retention rate. Study participants reported improvement from baseline compared to 3 months as follows (paired t test): Brief Pain Inventory (P<.001), AUSCAN pain subscale (P=.007), AUSCAN function subscale (P=.004), Fatigue Symptom Inventory (P=.004) and PSQI (P<.001), and HFRDIS (P=.02) and CES-D (P<.001). In particular, for our primary end point of interest, improvements in hip and knee symptoms, measured by WOMAC’s three subscales, were clinically meaningful and statistically significant when adjusted for multiple comparisons from baseline to 3 months post intervention. Conclusions The COVID-19 global pandemic has resulted in the need to rethink how mind-body therapies can be delivered. This study demonstrated the feasibility, acceptability, and potential efficacy of a telehealth-based tai chi intervention for reducing AI-induced arthralgia. The intervention decreased patient-reported pain and stiffness, and improved sleep quality and depressive symptoms. Fully powered, large, telehealth-based tai chi trials for AI-associated arthralgia are needed considering our promising findings. Trial Registration ClinicalTrials.gov NCT04716920; https://www.clinicaltrials.gov/ct2/show/NCT04716920
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Affiliation(s)
- Sameh Gomaa
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Carly West
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Ana Maria Lopez
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Tingting Zhan
- Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, United States
| | - Max Schnoll
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Maysa Abu-Khalaf
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Andrew Newberg
- Department of Integrative Medicine and Nutritional Sciences, Thomas Jefferson University, Philadelphia, PA, United States
| | - Kuang-Yi Wen
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
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5
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Jones C, Qi M, Xie Z, Moyle W, Weeks B, Li P. Baduanjin Exercise for Adults Aged 65 Years and Older: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. J Appl Gerontol 2021; 41:1244-1256. [PMID: 34949144 DOI: 10.1177/07334648211059324] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study performed a systematic review and meta-analysis to evaluate the health effects of Baduanjin exercise on adults aged 65 years and older. Chinese and English databases were electronically searched using search terms related to the PICO model from inception through June 2021. The study quality assessment and meta-analysis were conducted using the PEDro scale and RevMan 5.4 software. Eleven included Chinese studies, published between 2015 and 2021, recruited participants from the mainland of China. The aggregated results showed significant benefits of Baduanjin on physical function, walking ability, balance, and anxiety. A long-term Baduanjin intervention could also improve quality of life and reduce falls and pain. Baduanjin appears to have the potential to improve the health of older adults, but conclusions are limited due to the lack of rigorous and robust studies within and outside of mainland China. Larger, well-designed RCTs are needed to confirm these findings.
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Affiliation(s)
- Cindy Jones
- Faculty of Health Sciences and Medicine, 203555Bond University, Gold Coast, QLD, Australia.,Menzies Health Institute Queensland, 205723Griffith University, Brisbane, QLD, Australia
| | - Meiling Qi
- School of Nursing and Rehabilitation, 12589Shandong University, Jinan, China
| | - Zihui Xie
- School of Nursing and Rehabilitation, 12589Shandong University, Jinan, China
| | - Wendy Moyle
- Menzies Health Institute Queensland, 205723Griffith University, Brisbane, QLD, Australia.,School of Nursing and Midwifery, 16741Griffith University, Brisbane, QLD, Australia
| | - Benjamin Weeks
- Menzies Health Institute Queensland, 205723Griffith University, Brisbane, QLD, Australia.,School of Allied Health Sciences, 16741Griffith University, Gold Coast, QLD, Australia
| | - Ping Li
- School of Nursing and Rehabilitation, 12589Shandong University, Jinan, China
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Yang L, Winters-Stone K, Rana B, Cao C, Carlson LE, Courneya KS, Friedenreich CM, Schmitz KH. Tai Chi for cancer survivors: A systematic review toward consensus-based guidelines. Cancer Med 2021; 10:7447-7456. [PMID: 34533284 PMCID: PMC8559497 DOI: 10.1002/cam4.4273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 12/21/2022] Open
Abstract
To manage acute, long‐term, and late effects of cancer, current guidelines recommend moderate‐to‐vigorous intensity aerobic and resistance exercise. Unfortunately, not all cancer survivors are able or willing to perform higher intensity exercise during difficult cancer treatments or because of other existing health conditions. Tai Chi is an equipment‐free, multicomponent mind–body exercise performed at light‐to‐moderate intensity that may provide a more feasible alternative to traditional exercise programs for some cancer survivors. This systematic review evaluated the therapeutic efficacy of Tai Chi across the cancer care continuum. We searched MEDLINE/PubMed, Embase, SCOPUS, and CINAHL databases for interventional studies from inception to 18 September 2020. Controlled trials of the effects of Tai Chi training on patient‐reported and objectively measured outcomes in cancer survivors were included. Study quality was determined by the RoB 2 tool, and effect estimates were evaluated using the Best Evidence Synthesis approach. Twenty‐six reports from 14 trials (one non‐randomized controlled trial) conducted during (n = 5) and after treatment (after surgery: n = 2; after other treatments: n = 7) were included. Low‐level evidence emerged to support the benefits of 40–60 min of thrice‐weekly supervised Tai Chi for 8–12 weeks to improve fatigue and sleep quality in cancer survivors. These findings need to be confirmed in larger trials and tested for scaling‐up potential. Insufficient evidence was available to evaluate the effects of Tai Chi on other cancer‐related outcomes. Future research should examine whether Tai Chi training can improve a broader range of cancer outcomes including during the pre‐treatment and end of life phases.
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Affiliation(s)
- Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada.,Departments of Oncology, University of Calgary, Calgary, Canada.,Departments of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Kerri Winters-Stone
- School of Nursing and Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Benny Rana
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada
| | - Chao Cao
- Program in Physical Therapy, Washington University School of Medicine, St Louis, Missouri, USA
| | - Linda E Carlson
- Departments of Oncology, University of Calgary, Calgary, Canada.,Department of Psychosocial Oncology, Alberta Health Services, Calgary, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada.,Departments of Oncology, University of Calgary, Calgary, Canada.,Departments of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Kathryn H Schmitz
- Penn State Cancer Institute, Penn State College of Medicine, Hershey, Pennsylvania, USA
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Informational support for depression and quality of life improvements in older patients with cancer: a systematic review and meta-analysis. Support Care Cancer 2021; 30:1065-1077. [PMID: 34415425 DOI: 10.1007/s00520-021-06494-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/07/2021] [Indexed: 01/14/2023]
Abstract
PURPOSE To assess and summarize the effects of informational support on depression and quality of life of older patients with cancer. METHODS PubMed, MEDLINE, and Web of Science were searched to identify articles written in English and published until March 2021. Studies within 10 years period (2010-2021) were included. Randomized controlled trials were included if they evaluated the impact of informational support on depression and quality of life. All analyses were performed with Review Manager 5.3. RESULTS Twelve studies with a total of 2374 participants met the inclusion criteria. Our primary outcomes included depression and quality of life. (1) Depression: results indicated no statistically significant difference and low heterogeneity [SMD = 0.28, 95% CI (- 0.24,0.80), p = 0.45; I2 = 0%], (2) Quality of life: in the subgroup analyses of EORTC QLQ-C30, results indicated a significant effect of informational support on quality of life [SMD = 2.84, 95% CI (0.63, 5.05), p = 0.03; I2 = 79%]; in the subgroup analyses of FACT and SF-36, there were no significance. CONCLUSIONS Informational support could reduce depression and did improve the quality of life in older cancer patients with statistical significance. The findings suggested that informational support was an effective approach to improve depression and quality of life in older patients with cancer.
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8
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Yao LQ, Tan JYB, Turner C, Wang T. Feasibility and potential effects of tai chi for the fatigue-sleep disturbance-depression symptom cluster in patients with breast cancer: protocol of a preliminary randomised controlled trial. BMJ Open 2021; 11:e048115. [PMID: 34408044 PMCID: PMC8375769 DOI: 10.1136/bmjopen-2020-048115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The fatigue-sleep disturbance-depression symptom cluster (FSDSC) is one of the most common and debilitating side effects in patients with breast cancer (BC) throughout their treatment trajectory. Tai chi has been supported as a promising non-pharmacological intervention for the individual symptom relief of cancer-related fatigue, sleep disturbance and depression. However, relevant evidence of using tai chi for FSDSC management in patients with BC has been lacking. METHODS This study will be a two-arm, single-blinded pilot randomised controlled trial involving an 8-week intervention and a 4-week follow-up. Seventy-two patients with BC experiencing the FSDSC will be recruited from two tertiary medical centres in China. The participants will be randomised to either a tai chi group (n=36) or a control group (n=36). The participants in the tai chi group will receive an 8-week tai chi intervention in addition to standard care, while the participants in the control group will receive standard care only consisting of a booklet on the self-management of cancer symptoms. The primary outcomes will include a series of feasibility assessments of the study protocol in relation to the study's methodological procedures, including subject recruitment and follow-up process, completion of study questionnaires and the feasibility, acceptability and safety of the intervention. The secondary outcomes will be the clinical outcomes regarding the effects of tai chi on the FSDSC and quality of life, which will be evaluated by the Brief Fatigue Inventory, the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale and the Functional Assessment of Cancer Therapy-Breast questionnaires. ETHICS AND DISSEMINATION Ethics approval was obtained from relevant sites (H19094, KY2019133, 201932). The findings of the study will be published in peer-reviewed scientific journals and at conferences. TRAIL REGISTRATION NUMBER NCT04190342; Pre-results.
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Affiliation(s)
- Li-Qun Yao
- College of Nursing and Midwifery, CDU Brisbane Centre, Charles Darwin University, Brisbane, Queensland, Australia
| | - Jing-Yu Benjamin Tan
- College of Nursing and Midwifery, CDU Brisbane Centre, Charles Darwin University, Brisbane, Queensland, Australia
| | - Catherine Turner
- College of Nursing and Midwifery, CDU Brisbane Centre, Charles Darwin University, Brisbane, Queensland, Australia
| | - Tao Wang
- College of Nursing and Midwifery, CDU Brisbane Centre, Charles Darwin University, Brisbane, Queensland, Australia
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Sur D, Sabarimurugan S, Advani S. The Effects of Martial Arts on Cancer-Related Fatigue and Quality of Life in Cancer Patients: An Up-to-Date Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6116. [PMID: 34204027 PMCID: PMC8201183 DOI: 10.3390/ijerph18116116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND To evaluate and synthesize the existing evidence of the effects of practicing martial arts by cancer patients and cancer survivors in relation to overall quality of life (QoL) and cancer-related fatigue (CRF). METHODS Randomized controlled trials (RCTs) from 1 January 2000 to 5 November 2020 investigating the impact of martial arts were compared with any control intervention for overall QoL and CRF among cancer patients and survivors. Publication quality and risk of bias were assessed using the Cochrane handbook of systematic reviews. RESULTS According to the electronic search, 17 RCTs were retrieved including 1103 cancer patients. Martial arts significantly improved social function, compared to that in the control group (SMD = -0.88, 95% CI: -1.36, -0.39; p = 0.0004). Moreover, martial arts significantly improved functioning, compared to the control group (SMD = 0.68, 95% CI: 0.39-0.96; p < 0.00001). Martial arts significantly reduced CRF, compared to that in the control group (SMD = -0.51, 95% CI: -0.80, -0.22; p = 0.0005, I2 > 95%). CONCLUSIONS The results of our systematic review and meta-analysis reveal that the effects of practicing martial arts on CRF and QoL in cancer patients and survivors are inconclusive. Some potential effects were seen for social function and CRF, although the results were inconsistent across different measurement methods. There is a need for larger and more homogeneous clinical trials encompassing different cancer types and specific martial arts disciplines to make more extensive and definitive cancer- and symptom-specific recommendations.
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Affiliation(s)
- Daniel Sur
- 11th Department of Medical Oncology, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400015 Cluj-Napoca, Romania
- Department of Medical Oncology, Oncology Institute “Prof. Dr. Ion Chiricuta”, 400015 Cluj-Napoca, Romania
| | - Shanthi Sabarimurugan
- School of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Western Australia, Nedlands, WA 6009, Australia;
| | - Shailesh Advani
- Terasaki Institute of Biomedical Innovation, Los Angeles, CA 90024, USA;
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10
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Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5558805. [PMID: 33777155 PMCID: PMC7972853 DOI: 10.1155/2021/5558805] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 12/22/2022]
Abstract
Objectives This systematic review aims to summarize the existing literature on Tai Chi randomized controlled trials (RCTs) and recommend Tai Chi exercise prescriptions for different diseases and populations. Methods A systematic search for Tai Chi RCTs was conducted in five electronic databases (PubMed, Cochrane Library, EMBASE, EBSCO, and Web of Science) from their inception to December 2019. SPSS 20.0 software and Microsoft Excel 2019 were used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of RCTs. Results A total of 139 articles were identified, including diseased populations (95, 68.3%) and healthy populations (44, 31.7%). The diseased populations included the following 10 disease types: musculoskeletal system or connective tissue diseases (34.7%), circulatory system diseases (23.2%), mental and behavioral disorders (12.6%), nervous system diseases (11.6%), respiratory system diseases (6.3%), endocrine, nutritional or metabolic diseases (5.3%), neoplasms (3.2%), injury, poisoning and certain other consequences of external causes (1.1%), genitourinary system diseases (1.1%), and diseases of the eye and adnexa (1.1%). Tai Chi exercise prescription was generally classified as moderate intensity. The most commonly applied Tai Chi style was Yang style (92, 66.2%), and the most frequently specified Tai Chi form was simplified 24-form Tai Chi (43, 30.9%). 12 weeks and 24 weeks, 2-3 times a week, and 60 min each time was the most commonly used cycle, frequency, and time of exercise in Tai Chi exercise prescriptions. Conclusions We recommend the more commonly used Tai Chi exercise prescriptions for different diseases and populations based on clinical evidence of Tai Chi. Further clinical research on Tai Chi should be combined with principles of exercise prescription to conduct large-sample epidemiological studies and long-term prospective follow-up studies to provide more substantive clinical evidence for Tai Chi exercise prescriptions.
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11
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Zeng S, Liu Y, Wang X, Zhang L, Guo Y, Feng Q. Traditional Chinese Medicine Could Play an Important Role in Integrative Palliative Care in China. J Altern Complement Med 2020; 26:770-773. [PMID: 32924559 DOI: 10.1089/acm.2020.0160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
| | - Yefang Liu
- Third School of Clinical Medicine, Chengdu University of TCM, Chengdu, China
| | - Xiaoli Wang
- Third School of Clinical Medicine, Chengdu University of TCM, Chengdu, China
| | - Lu Zhang
- Chengdu University of TCM, Chengdu, China
| | - Yinling Guo
- Chengdu University of TCM, Chengdu, China.,School of Basic Medical Sciences, Chengdu University of TCM, Chengdu, China
| | - Quansheng Feng
- Chengdu University of TCM, Chengdu, China.,School of Basic Medical Sciences, Chengdu University of TCM, Chengdu, China
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12
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Song Y, Sun D, István B, Thirupathi A, Liang M, Teo EC, Gu Y. Current Evidence on Traditional Chinese Exercise for Cancers: A Systematic Review of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145011. [PMID: 32664702 PMCID: PMC7400020 DOI: 10.3390/ijerph17145011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/05/2020] [Accepted: 07/10/2020] [Indexed: 02/08/2023]
Abstract
Traditional Chinese exercise (TCE) has gradually become one of the widespread complementary therapies for treatment and recovery of cancers. However, evidence based on the systematic evaluation of its efficacy is lacking, and there appears to be no conclusion regarding the setting of TCE interventions. The purpose of this systematic review is to summarize the current randomized controlled trials (RCTs) that outline the effects of TCE on cancer patients. Relevant studies were searched by GOOGLE SCHOLAR, SCIENCEDIRECT, and WEB OF SCIENCE using “traditional Chinese exercise” and “cancer.” Only RCTs published in peer-reviewed English journals were included. A total of 27 studies covering 1616 cancer patients satisfied the eligibility criteria for this review. Despite the methodological limitation and relatively high risk of bias possessed by some included studies, positive evidence was still detected on the effects of TCE on these cancer-related health outcomes in physical, psychological, and physiological parameters. The 60-min or 90-min course of TCE intervention for two to three times per week for 10 to 12 weeks was found to be the most common setting in these studies and has effectively benefited cancer patients. These findings add scientific support to encourage cancer patients to practice TCE during or after conventional medical treatment. Nevertheless, future well-designed RCTs with improved methodology and larger sample size on this field are much warranted for further verification.
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Affiliation(s)
- Yang Song
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.S.); (D.S.); (A.T.); (M.L.); (E.-C.T.)
| | - Dong Sun
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.S.); (D.S.); (A.T.); (M.L.); (E.-C.T.)
| | - Bíró István
- Faculty of Engineering, University of Szeged, 6724 Szeged, Hungary;
| | - Anand Thirupathi
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.S.); (D.S.); (A.T.); (M.L.); (E.-C.T.)
| | - Minjun Liang
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.S.); (D.S.); (A.T.); (M.L.); (E.-C.T.)
| | - Ee-Chon Teo
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.S.); (D.S.); (A.T.); (M.L.); (E.-C.T.)
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 637459, Singapore
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.S.); (D.S.); (A.T.); (M.L.); (E.-C.T.)
- Correspondence: ; Tel.: +86-574-87600271
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Zhang Z, Giordani B, Chen W. Fidelity and feasibility of a multicomponent physical activity intervention in a retirement community. Geriatr Nurs 2019; 41:394-399. [PMID: 31899004 DOI: 10.1016/j.gerinurse.2019.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/08/2019] [Accepted: 12/10/2019] [Indexed: 11/26/2022]
Abstract
This pilot study examined the fidelity and feasibility of a multicomponent physical activity intervention in a retirement community. Eighteen older adults participated in an 8-week intervention. The intervention included offering group exercise lessons, combined with providing participants wearable activity trackers. Quantitative and qualitative data were collected to assess the feasibility and fidelity. The retention of the study was 83.3% and the average attendance of group lessons was 88.2%. Participants wore the activity trackers on 93.9% of the required days. Individual interviews indicated that participants were generally satisfied with the intervention. However, the Tai Chi session of exercise lessons and the activity trackers were not favored by the majority of the participants. Future interventions should provide tailored and adaptable exercise programs to meet the various physical health conditions of older adults and ease the use of technology to facilitate behavior change.
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Affiliation(s)
- Zhanjia Zhang
- School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Bruno Giordani
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Weiyun Chen
- School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA.
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Influence of Tai Chi on Self-Efficacy, Quality of Life, and Fatigue Among Patients With Cancer Receiving Chemotherapy: A Pilot Study Brief. J Holist Nurs 2019; 37:354-363. [DOI: 10.1177/0898010119867557] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: While exercise is an effective intervention used to minimize side effects associated with chemotherapy, tai chi (TC) exercise for persons actively receiving chemotherapy remains understudied. The purposes of this study were to (a) evaluate the effects of TC on self-efficacy, quality of life (QOL), and cancer-related fatigue (CRF) and (b) understand the experience and perceived benefits of patients taking chemotherapy involved in a TC program. Design: An explanatory sequential mixed methods study with a dominant qualitative strand was used to explore the differences between an intervention group participating in TC ( n = 3) and a nonexercising, wait-listed comparison group ( n = 3). Method: Following 8-weeks of TC classes, a focus group was conducted with the intervention group. Pretest/posttest scores for CRF, self-efficacy, and QOL were analyzed using t tests to compare the means between and within groups. Thematic analysis was used to interpret transcripts. Quantitative and qualitative results were compared to determine congruence between findings. Findings: Qualitative findings revealed increased mind/body strength. Quantitative scores trended toward improved CRF, self-efficacy, and QOL. Findings from the two strands supported one another. Conclusions: Tai chi is an effective and feasible exercise for individuals with cancer receiving chemotherapy. This mind–body exercise appears to provide benefits beyond improved physical functioning.
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15
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The effects of Tai Chi on quality of life of cancer survivors: a systematic review and meta-analysis. Support Care Cancer 2019; 27:3701-3716. [DOI: 10.1007/s00520-019-04911-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
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16
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Maindet C, Burnod A, Minello C, George B, Allano G, Lemaire A. Strategies of complementary and integrative therapies in cancer-related pain-attaining exhaustive cancer pain management. Support Care Cancer 2019; 27:3119-3132. [PMID: 31076901 DOI: 10.1007/s00520-019-04829-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 04/23/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Complementary integrative therapies (CITs) correspond to growing demand in patients with cancer-related pain. This demand needs to be considered alongside pharmaceutical and/or interventional therapies. CITs can be used to cover certain specific pain-related characteristics. The objective of this review is to present the options for CITs that could be used within dynamic, multidisciplinary, and personalized management, leading to an integrative oncology approach. METHODS Critical reflection based on literature analysis and clinical practice. RESULTS Most CITs only showed trends in efficacy as cancer pain was mainly a secondary endpoint, or populations were restricted. Physical therapy has demonstrated efficacy in motion and pain, in some specific cancers (head and neck or breast cancers) or in treatments sequelae (lymphedema). In cancer survivors, higher levels of physical activity decrease pain intensity. Due to the multimorphism of cancer pain, certain mind-body therapies acting on anxiety, stress, depression, or mood disturbances (such as massage, acupuncture, healing touch, hypnosis, and music therapy) are efficient on cancer pain. Other mind-body therapies have shown trends in reducing the severity of cancer pain and improving other parameters, and they include education (with coping skills training), yoga, tai chi/qigong, guided imagery, virtual reality, and cognitive-behavioral therapy alone or combined. The outcome sustainability of most CITs is still questioned. CONCLUSIONS High-quality clinical trials should be conducted with CITs, as their efficacy on pain is mainly based on efficacy trends in pain severity, professional judgment, and patient preferences. Finally, the implementation of CITs requires an interdisciplinary team approach to offer optimal, personalized, cancer pain management.
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Affiliation(s)
- Caroline Maindet
- Pain management centre, Grenoble-Alpes University Hospital, Grenoble, France
| | - Alexis Burnod
- Department of supportive care, Institut Curie, PSL Research University, Paris, France
| | - Christian Minello
- Anaesthesia-intensive care department, Cancer Centre Georges François Leclerc, Dijon, France
| | | | - Gilles Allano
- Pain management unit, Mutualist Clinic of la Porte-de-l'Orient, Lorient, France
| | - Antoine Lemaire
- Oncology and medical specialties department, Valenciennes General Hospital, Valenciennes, France.
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17
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STRUNK MAXIMILIANALEXANDER, ZOPF EVAM, STECK JULE, HAMACHER STEFANIE, HALLEK MICHAEL, BAUMANN FREERKT. Effects of Kyusho Jitsu on Physical Activity-levels and Quality of Life in Breast Cancer Patients. In Vivo 2018; 32. [PMID: 29936464 PMCID: PMC6117768 DOI: 10.21873/invivo.112313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND/AIM Breast cancer survivors often report a decrease in physical activity levels and quality of life. The aim of this study was to explore whether a "Kyusho Jitsu" martial arts intervention is feasible and can improve general well-being and physical activity levels in breast cancer survivors. MATERIALS AND METHODS Breast cancer survivors (N=51) were randomly assigned to the intervention or control group. The intervention group participated in a 24-week Kyusho Jitsu intervention. Both groups were assessed at baseline, 3, and 6 months. RESULTS Analysis of original data showed several significant improvements in favor of the intervention group, but also some of the control group. Sensitivity analysis supports these findings. No adverse events were observed. CONCLUSION To our knowledge this is the first study showing that a holistic Kyusho Jitsu martial arts intervention can be feasible and effective for breast cancer survivors.
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Affiliation(s)
- MAXIMILIAN ALEXANDER STRUNK
- Department I of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany
| | - EVA M. ZOPF
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - JULE STECK
- Department I of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany
| | - STEFANIE HAMACHER
- Institute of Medical Statistics and Computational Biology University Hospital of Cologne, Cologne, Germany
| | - MICHAEL HALLEK
- Department I of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany
| | - FREERK T. BAUMANN
- Department I of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany
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Strunk MA, Zopf EM, Steck J, Hamacher S, Hallek M, Baumann FT. Effects of Kyusho Jitsu on Physical Activity-levels and Quality of Life in Breast Cancer Patients. In Vivo 2018; 32:819-824. [PMID: 29936464 PMCID: PMC6117768 DOI: 10.21873/invivo.11313] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/31/2018] [Accepted: 04/02/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND/AIM Breast cancer survivors often report a decrease in physical activity levels and quality of life. The aim of this study was to explore whether a "Kyusho Jitsu" martial arts intervention is feasible and can improve general well-being and physical activity levels in breast cancer survivors. MATERIALS AND METHODS Breast cancer survivors (N=51) were randomly assigned to the intervention or control group. The intervention group participated in a 24-week Kyusho Jitsu intervention. Both groups were assessed at baseline, 3, and 6 months. RESULTS Analysis of original data showed several significant improvements in favor of the intervention group, but also some of the control group. Sensitivity analysis supports these findings. No adverse events were observed. CONCLUSION To our knowledge this is the first study showing that a holistic Kyusho Jitsu martial arts intervention can be feasible and effective for breast cancer survivors.
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Affiliation(s)
- Maximilian Alexander Strunk
- Department I of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany
| | - Eva M Zopf
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Jule Steck
- Department I of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany
| | - Stefanie Hamacher
- Institute of Medical Statistics and Computational Biology University Hospital of Cologne, Cologne, Germany
| | - Michael Hallek
- Department I of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany
| | - Freerk T Baumann
- Department I of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany
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Freedman RA, Partridge AH. Emerging Data and Current Challenges for Young, Old, Obese, or Male Patients with Breast Cancer. Clin Cancer Res 2018; 23:2647-2654. [PMID: 28572259 DOI: 10.1158/1078-0432.ccr-16-2552] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/20/2017] [Accepted: 04/04/2017] [Indexed: 11/16/2022]
Abstract
There are distinct subgroups of patients who have historically been underrepresented in most prospective clinical trials in breast cancer, including the youngest and oldest patients, male patients, and those struggling with obesity. Herein, we review current and future directions in research for each of these special populations with breast cancer, highlighting significant knowledge gaps and priorities in tumor biology and heterogeneity, therapeutic decision making promotion of adherence, supportive care, and psychosocial and functional well-being. In younger women, future study should focus on the biological underpinnings of aggressive disease and optimizing adherence and treatment decision making while addressing their unique survivorship needs. The latter includes generating a scientific basis for interruption of therapy for pregnancy. Among older patients, interventions should focus on increasing clinical trial accrual, predicting and mitigating toxicity so that functional status can be optimized, tailoring needs for dose modification, and anticipating life expectancy in the context of competing causes of death. For men with breast cancer, we need worldwide collaboration to answer even basic questions on optimal treatment, supportive care, and survivorship strategies. Finally, for those struggling with obesity, we need to better understand the biological associations with cancer incidence, prognosis and outcome, and how we can best intervene to assure weight loss at the "right time." It is only through highly collaborative, far-reaching, prospective, multidisciplinary, patient-centered, and patient-engaged efforts that we can optimize the physical and psychologic outcomes for all patients with breast cancer. Clin Cancer Res; 23(11); 2647-54. ©2017 AACRSee all articles in this CCR Focus section, "Breast Cancer Research: From Base Pairs to Populations."
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20
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Liu L, Petrich S, McLaren B, Kelly L, Baxter GD. An integrative Tai Chi program for patients with breast cancer undergoing cancer therapy: study protocol for a randomized controlled feasibility study. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2018. [PMID: 29526243 DOI: 10.1016/j.joim.2017.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Breast cancer patients experience various side effects during cancer therapy, often resulting in reduced quality of life and poor adherence to treatment. A limited range of proven interventions has been developed to target such side effects. While Tai Chi offers benefits for the health and well-being of breast cancer survivors, the effectiveness of Tai Chi across the treatment continuum has not been evaluated. Improved patient education and support has been suggested as a priority for breast cancer care. This pilot study assesses the feasibility of a randomized controlled trial (RCT) to evaluate the effectiveness of "an integrative Tai Chi" (ANITA) program for breast cancer patients undergoing cancer therapy. METHODS/DESIGN This is a single-centre, two-arm feasibility RCT. Twenty-four patients with breast cancer who have undergone surgical treatment will be recruited from the Dunedin Hospital (New Zealand) over a 12-month period (from August 2017 to July 2018). Subject to informed consent, patients will be randomized to receive standard cancer treatment alone or standard cancer treatment plus the ANITA program, consisting of peer support, health education, and Tai Chi Ruler exercise. The program runs alongside the patient's adjuvant cancer therapy, which may include chemotherapy, radiation therapy, antibody treatment, and/or antihormonal therapy. Analysis in this study will focus on process evaluation of participant recruitment, retention, treatment fidelity, acceptability of the program, and occurrence of adverse events. Clinical outcomes (i.e., fatigue, sleep quality, anxiety and depression and quality of life) will be assessed at baseline, and at 12 weeks and 24 weeks post-randomization. DISCUSSION Outcomes from this study will inform the feasibility and methodology for a future fully-powered RCT. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry with the identifier ACTRN12617000975392.
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Affiliation(s)
- Lizhou Liu
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand.
| | - Simone Petrich
- Department of Surgical Sciences, Southern District Health Board, Dunedin 9016, New Zealand
| | - Blair McLaren
- Oncology Department, Southern District Health Board, Dunedin 9016, New Zealand
| | - Lyndell Kelly
- Oncology Department, Southern District Health Board, Dunedin 9016, New Zealand
| | - G David Baxter
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand
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Tai Chi and Qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis. J Cancer Surviv 2017; 12:256-267. [PMID: 29222705 DOI: 10.1007/s11764-017-0665-5] [Citation(s) in RCA: 127] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 11/29/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE This study aims to summarize and critically evaluate the effects of Tai Chi and Qigong (TCQ) mind-body exercises on symptoms and quality of life (QOL) in cancer survivors. METHODS A systematic search in four electronic databases targeted randomized and non-randomized clinical studies evaluating TCQ for fatigue, sleep difficulty, depression, pain, and QOL in cancer patients, published through August 2016. Meta-analysis was used to estimate effect sizes (ES, Hedges' g) and publication bias for randomized controlled trials (RCTs). Methodological bias in RCTs was assessed. RESULTS Our search identified 22 studies, including 15 RCTs that evaluated 1283 participants in total, 75% women. RCTs evaluated breast (n = 7), prostate (n = 2), lymphoma (n = 1), lung (n = 1), or combined (n = 4) cancers. RCT comparison groups included active intervention (n = 7), usual care (n = 5), or both (n = 3). Duration of TCQ training ranged from 3 to 12 weeks. Methodological bias was low in 12 studies and high in 3 studies. TCQ was associated with significant improvement in fatigue (ES = - 0.53, p < 0.001), sleep difficulty (ES = - 0.49, p = 0.018), depression (ES = - 0.27, p = 0.001), and overall QOL (ES = 0.33, p = 0.004); a statistically non-significant trend was observed for pain (ES = - 0.38, p = 0.136). Random effects models were used for meta-analysis based on Q test and I 2 criteria. Funnel plots suggest some degree of publication bias. Findings in non-randomized studies largely paralleled meta-analysis results. CONCLUSIONS Larger and methodologically sound trials with longer follow-up periods and appropriate comparison groups are needed before definitive conclusions can be drawn, and cancer- and symptom-specific recommendations can be made. IMPLICATIONS FOR CANCER SURVIVORS TCQ shows promise in addressing cancer-related symptoms and QOL in cancer survivors.
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23
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Greenlee H, DuPont-Reyes MJ, Balneaves LG, Carlson LE, Cohen MR, Deng G, Johnson JA, Mumber M, Seely D, Zick SM, Boyce LM, Tripathy D. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin 2017; 67:194-232. [PMID: 28436999 PMCID: PMC5892208 DOI: 10.3322/caac.21397] [Citation(s) in RCA: 407] [Impact Index Per Article: 58.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. CA Cancer J Clin 2017;67:194-232. © 2017 American Cancer Society.
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Affiliation(s)
- Heather Greenlee
- Assistant Professor, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
- Member, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY
| | - Melissa J DuPont-Reyes
- Doctoral Fellow, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Lynda G Balneaves
- Associate Professor, College of Nursing, Rady Faculty of Health Sciences, Winnipeg, MB, Canada
| | - Linda E Carlson
- Professor, Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - Misha R Cohen
- Adjunct Professor, American College of Traditional Chinese Medicine at California Institute of Integral Studies, San Francisco, CA
- Clinic Director, Chicken Soup Chinese Medicine, San Francisco, CA
| | - Gary Deng
- Medical Director, Integrative Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jillian A Johnson
- Post-Doctoral Scholar, Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA
| | | | - Dugald Seely
- Executive Director, Ottawa Integrative Cancer Center, Ottawa, ON, Canada
- Executive Director of Research, Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Suzanna M Zick
- Research Associate Professor, Department of Family Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI
- Research Associate Professor, Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Lindsay M Boyce
- Research Informationist, Memorial Sloan Kettering Library, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Debu Tripathy
- Professor, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Use of Salivary Diurnal Cortisol as an Outcome Measure in Randomised Controlled Trials: a Systematic Review. Ann Behav Med 2016; 50:210-36. [PMID: 27007274 PMCID: PMC4823366 DOI: 10.1007/s12160-015-9753-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is associated with diverse adverse health outcomes, making it an important therapeutic target. Measurement of the diurnal rhythm of cortisol secretion provides a window into this system. At present, no guidelines exist for the optimal use of this biomarker within randomised controlled trials (RCTs). Purpose The aim of this study is to describe the ways in which salivary diurnal cortisol has been measured within RCTs of health or behavioural interventions in adults. Methods Six electronic databases (up to May 21, 2015) were systematically searched for RCTs which used salivary diurnal cortisol as an outcome measure to evaluate health or behavioural interventions in adults. A narrative synthesis was undertaken of the findings in relation to salivary cortisol methodology and outcomes. Results From 78 studies that fulfilled the inclusion criteria, 30 included healthy participants (38.5 %), 27 included patients with physical disease (34.6 %) and 21 included patients with psychiatric disease (26.9 %). Psychological therapies were most commonly evaluated (n = 33, 42.3 %). There was substantial heterogeneity across studies in relation to saliva collection protocols and reported cortisol parameters. Only 39 studies (50 %) calculated a rhythm parameter such as the diurnal slope or the cortisol awakening response (CAR). Patterns of change in cortisol parameters were inconsistent both within and across studies and there was low agreement with clinical findings. Conclusions Salivary diurnal cortisol is measured inconsistently across RCTs, which is limiting the interpretation of findings within and across studies. This indicates a need for more validation work, along with consensus guidelines. Electronic supplementary material The online version of this article (doi:10.1007/s12160-015-9753-9) contains supplementary material, which is available to authorized users.
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Tao W, Luo X, Cui B, Liang D, Wang C, Duan Y, Li X, Zhou S, Zhao M, Li Y, He Y, Wang S, Kelley KW, Jiang P, Liu Q. Practice of traditional Chinese medicine for psycho-behavioral intervention improves quality of life in cancer patients: A systematic review and meta-analysis. Oncotarget 2016; 6:39725-39. [PMID: 26498685 PMCID: PMC4741858 DOI: 10.18632/oncotarget.5388] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/02/2015] [Indexed: 11/30/2022] Open
Abstract
Background Cancer patients suffer from diverse symptoms, including depression, anxiety, pain, and fatigue and lower quality of life (QoL) during disease progression. This study aimed to evaluate the benefits of Traditional Chinese Medicine psycho-behavioral interventions (TCM PBIs) on improving QoL by meta-analysis. Methods Electronic literature databases (PubMed, CNKI, VIP, and Wanfang) were searched for randomized, controlled trials conducted in China. The primary intervention was TCM PBIs. The main outcome was health-related QoL (HR QoL) post-treatment. We applied standard meta analytic techniques to analyze data from papers that reached acceptable criteria. Results The six TCM PBIs analyzed were acupuncture, Chinese massage, Traditional Chinese Medicine five elements musical intervention (TCM FEMI), Traditional Chinese Medicine dietary supplement (TCM DS), Qigong and Tai Chi. Although both TCM PBIs and non-TCM PBIs reduced functional impairments in cancer patients and led to pain relief, depression remission, reduced time to flatulence following surgery and sleep improvement, TCM PBIs showed more beneficial effects as assessed by reducing both fatigue and gastrointestinal distress. In particular, acupuncture relieved fatigue, reduced diarrhea and decreased time to flatulence after surgery in cancer patients, while therapeutic Chinese massage reduced time to flatulence and time to peristaltic sound. Conclusion These findings demonstrate the efficacy of TCM PBIs in improving QoL in cancer patients and establish that TCM PBIs represent beneficial adjunctive therapies for cancer patients.
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Affiliation(s)
- Weiwei Tao
- Institute of Cancer Stem Cell, Cancer Center, Dalian Medical University, Dalian, China.,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong, China.,College of Nursing, Dalian Medical University, Dalian, China
| | - Xi Luo
- Institute of Cancer Stem Cell, Cancer Center, Dalian Medical University, Dalian, China.,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong, China
| | - Bai Cui
- Institute of Cancer Stem Cell, Cancer Center, Dalian Medical University, Dalian, China.,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong, China
| | - Dapeng Liang
- Institute of Cancer Stem Cell, Cancer Center, Dalian Medical University, Dalian, China.,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong, China
| | - Chunli Wang
- Institute of Cancer Stem Cell, Cancer Center, Dalian Medical University, Dalian, China.,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong, China
| | - Yangyang Duan
- Department of Radiology, Second Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Xiaofen Li
- School of Public Health, Dalian Medical University, Dalian, China
| | - Shiyu Zhou
- Department of Psychology, Dalian Medical University, Dalian, China
| | - Mingjie Zhao
- Dalian Medical University Magazine, Dalian, China
| | - Yi Li
- School of Art, Dalian Medical University, Dalian, China
| | - Yumin He
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shaowu Wang
- Department of Radiology, Second Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Keith W Kelley
- Integrative Immunology and Behavior Program, Department of Animal Sciences, College of ACES, Urbana, IL, USA.,Department of Pathology, College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Ping Jiang
- Graduate School, Dalian Medical University, Dalian, China
| | - Quentin Liu
- Institute of Cancer Stem Cell, Cancer Center, Dalian Medical University, Dalian, China.,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong, China
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Desrochers P, Kairy D, Pan S, Corriveau H, Tousignant M. Tai chi for upper limb rehabilitation in stroke patients: the patient's perspective. Disabil Rehabil 2016; 39:1313-1319. [PMID: 27347600 DOI: 10.1080/09638288.2016.1194900] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This study aimed at exploring the perceived benefits and drawbacks of practicing tai chi, an alternative therapy that can be implemented in the community, as part of upper-limb rehabilitation following stroke. METHODOLOGY Semistructured interviews were carried out with participants with chronic stroke (>6 months). The participants took part in 16 tai chi sessions over 8 weeks. Interviews were conducted in person using an interview guide based on the theory of planned behavior (TPB), and a thematic analysis was conducted. RESULTS Eight interviews were carried out with participants at various stages of motor recovery. Participants perceived a number of physical, functional, and psychological benefits. They found tai chi to be a global exercise, including both physical and mental aspects, and suggested that it can be included as part of rehabilitation for stroke patients. Many participants expressed a desire to continue practicing tai chi after completion of the study because it exceeded their expectations, among other reasons. CONCLUSION This study can serve to guide future tai chi interventions and research on tai chi for rehabilitation in terms of the characteristics of the intervention and the various areas to assess in order to measure the overall benefits. IMPLICATIONS FOR REHABILITATION Tai chi was perceived as a good way of integrating various skills learned during rehabilitation. Despite having different functional abilities, all the participants noted various physical, functional, and psychological benefits from participating in the tai chi sessions. Tai chi seems to be a form of exercise that stroke patients would perform more long-term since all the participants in this study expressed the desire to continue practicing tai chi.
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Affiliation(s)
- Pascal Desrochers
- a School of Rehabilitation, Université de Montréal , Montreal , Quebec , Canada
| | - Dahlia Kairy
- a School of Rehabilitation, Université de Montréal , Montreal , Quebec , Canada.,b Center for Interdisciplinary Research in Rehabilitation of Greater Montreal - IRGLM Site , Montreal , Quebec , Canada
| | - Shujuan Pan
- a School of Rehabilitation, Université de Montréal , Montreal , Quebec , Canada
| | - Hélène Corriveau
- c School of Rehabilitation, Université de Sherbrooke , Sherbrooke , QC , Canada.,d Research Center on Aging, University Institute of Geriatrics of Sherbrooke , Sherbrooke , QC , Canada
| | - Michel Tousignant
- c School of Rehabilitation, Université de Sherbrooke , Sherbrooke , QC , Canada.,d Research Center on Aging, University Institute of Geriatrics of Sherbrooke , Sherbrooke , QC , Canada
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Integrative Therapies for Cancer Survivors. TOPICS IN GERIATRIC REHABILITATION 2015. [DOI: 10.1097/tgr.0000000000000080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chen YW, Hunt MA, Campbell KL, Peill K, Reid WD. The effect of Tai Chi on four chronic conditions—cancer, osteoarthritis, heart failure and chronic obstructive pulmonary disease: a systematic review and meta-analyses. Br J Sports Med 2015; 50:397-407. [DOI: 10.1136/bjsports-2014-094388] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2015] [Indexed: 01/15/2023]
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Tai chi chuan exercise for patients with breast cancer: a systematic review and meta-analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:535237. [PMID: 25793000 PMCID: PMC4352428 DOI: 10.1155/2015/535237] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 12/21/2014] [Indexed: 11/23/2022]
Abstract
Objective. Tai Chi Chuan (TCC) is a form of aerobic exercise that may be an effective therapy for improving psychosomatic capacity among breast cancer survivors. This meta-analysis analyzed the available randomized controlled trials (RCTs) on the effects of TCC in relieving treatment-related side effects and quality of life in women with breast cancer. Methods. RCTs were searched in PubMed, Embase, Web of Science, and Cochrane Library through April 2014. Data were analyzed on pathology (pain, interleukin-6, and insulin-like growth factor 1), physical capacity (handgrip, limb physical fitness, and BMI), and well-being (physical, social, emotional, and general quality of life). Results. Nine RCTs, including a total of 322 breast cancer patients, were examined. Compared with control therapies, the pooled results suggested that TCC showed significant effects in improving handgrip dynamometer strength, limb elbow flexion (elbow extension, abduction, and horizontal adduction). No significant differences were observed in pain, interleukin-6, insulin-like growth factor, BMI, physical well-being, social or emotional well-being, or general health-related quality of life. Conclusion. The short-term effects of TCC may have potential benefits in upper limb functional mobility in patients with breast cancer. Additional randomized controlled trials with longer follow-up are needed to provide more reliable evidence.
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Campo RA, Light KC, O'Connor K, Nakamura Y, Lipschitz D, LaStayo PC, Pappas LM, Boucher KM, Irwin MR, Hill HR, Martins TB, Agarwal N, Kinney AY. Blood pressure, salivary cortisol, and inflammatory cytokine outcomes in senior female cancer survivors enrolled in a tai chi chih randomized controlled trial. J Cancer Surviv 2014; 9:115-25. [PMID: 25164513 DOI: 10.1007/s11764-014-0395-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 08/07/2014] [Indexed: 01/12/2023]
Abstract
PURPOSE Older cancer survivors are a vulnerable population due to an increased risk for chronic diseases (e.g., cardiovascular disease) compounded with treatment late-effects and declines in physical functioning. Therefore, interventions that reduce chronic disease risk factors (i.e., blood pressure, chronic inflammation, and cortisol) are important in this population. Tai chi chih (TCC) is a mind-body exercise associated with reductions in chronic disease risk factors, but has not been examined with older cancer survivors. In a feasibility randomized controlled trial of TCC, we examined secondary outcomes of blood pressure, salivary cortisol, and inflammatory cytokines (interleukin (IL)-6, IL-12, tumor necrosis factor-α, IL-10, IL-4) due to their implications in chronic diseases. METHODS Sixty-three senior female cancer survivors (M age = 67 years, SD = 7.15) with physical functioning limitations (SF-12 physical functioning ≤80 or role-physical ≤72) were randomized to 12-weeks (60-min, three times a week) of TCC or Health Education control (HEC) classes. Resting blood pressure, 1-day salivary cortisol samples, and fasting plasma samples for cytokine multiplex assays were collected at baseline and 1-week post-intervention. RESULTS Controlling for baseline values, the TCC group had significantly lower systolic blood pressure (SBP, p = 0.002) and cortisol area-under-curve (AUC, p = 0.02) at post-intervention than the HEC group. There was no intervention effect on inflammatory cytokines (p's > 0.05). CONCLUSIONS This TCC feasibility trial was associated with significant reductions in SBP and cortisol AUC in senior female cancer survivors. Larger, definitive trials are needed to confirm these findings. IMPLICATIONS FOR CANCER SURVIVORS Senior survivors' have an increased risk for chronic diseases; however, TCC interventions may help reduce associated risk factors.
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Affiliation(s)
- Rebecca A Campo
- Program on Integrative Medicine, Department of Physical Medicine & Rehabilitation, University of North Carolina at Chapel Hill, CB# 7200, Chapel Hill, NC, 27599-7200, USA,
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Li G, Yuan H, Zhang W. Effects of Tai Chi on health related quality of life in patients with chronic conditions: A systematic review of randomized controlled trials. Complement Ther Med 2014; 22:743-55. [DOI: 10.1016/j.ctim.2014.06.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 05/14/2014] [Accepted: 06/23/2014] [Indexed: 10/25/2022] Open
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Zeng Y, Luo T, Xie H, Huang M, Cheng AS. Health benefits of qigong or tai chi for cancer patients: a systematic review and meta-analyses. Complement Ther Med 2014; 22:173-86. [DOI: 10.1016/j.ctim.2013.11.010] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 11/25/2013] [Accepted: 11/29/2013] [Indexed: 11/25/2022] Open
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Campo RA, Agarwal N, LaStayo PC, O'Connor K, Pappas L, Boucher KM, Gardner J, Smith S, Light KC, Kinney AY. Levels of fatigue and distress in senior prostate cancer survivors enrolled in a 12-week randomized controlled trial of Qigong. J Cancer Surviv 2013; 8:60-9. [PMID: 24170679 DOI: 10.1007/s11764-013-0315-5] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 09/28/2013] [Indexed: 12/20/2022]
Abstract
PURPOSE Fatigue is a commonly reported symptom by prostate cancer survivors and is associated with significant distress and declines in quality of life. Qigong is a mind-body activity that consists of both physical activity and meditative aspects. This 12-week randomized controlled trial examined the feasibility and efficacy of a Qigong intervention for improving older prostate cancer survivors' levels of fatigue and distress. METHODS Forty older (median age = 72, range = 58-93), fatigued (cut-off value of ≥ 1 on the CTCAEv4.0, >20 on a fatigue grading scale), and sedentary (<150 min of moderate exercise/week) prostate cancer survivors were randomized to 12 weeks of Qigong or stretching classes. Primary outcomes were feasibility (i.e., retention and class attendance rates) and fatigue [Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue)], and secondary outcome was distress [Brief Symptom Inventory-18 (BSI-18)]. RESULTS Study retention rates did not significantly differ between study groups (Qigong = 80 %, stretching = 65 %, p = 0.48). The Qigong group had significantly higher class attendance than the stretching group (p = 0.04). The Qigong group had significantly greater improvements in the FACIT-Fatigue (p = 0.02) and distress (i.e., BSI-18 Somatization, Anxiety, & Global Severity Index, p's < 0.05), than the Stretching group. CONCLUSIONS This 12-week Qigong intervention was feasible and potentially efficacious in improving senior prostate cancer survivors' levels of fatigue and distress levels. Future, larger definitive randomized controlled trials are needed to confirm these benefits in older prostate cancer survivors and in racially and ethnically diverse populations. IMPLICATIONS FOR CANCER SURVIVORS Qigong may be an effective nonpharmacological intervention for the management of senior prostate cancer survivors' fatigue and distress.
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Affiliation(s)
- Rebecca A Campo
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA,
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