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Esteban-Simón A, Díez-Fernández DM, Rodríguez-Pérez MA, Artés-Rodríguez E, Casimiro-Andújar AJ, Soriano-Maldonado A. Does a Resistance Training Program Affect Between-arms Volume Difference and Shoulder-arm Disabilities in Female Breast Cancer Survivors? The Role of Surgery Type and Treatments. Secondary Outcomes of the EFICAN Trial. Arch Phys Med Rehabil 2024; 105:647-654. [PMID: 38043674 DOI: 10.1016/j.apmr.2023.11.010] [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: 02/16/2023] [Revised: 10/03/2023] [Accepted: 11/08/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE The aims were (i) to assess the effects of a 12-week resistance training program on between-arms volume difference and shoulder-arm disabilities in breast cancer survivors and (ii) to evaluate whether the main risk factors for developing cancer-related lymphedema and shoulder-arm disabilities were associated with the effects of the training program. DESIGN Randomized controlled trial. SETTING University facilities. PARTICIPANTS 60 female breast cancer survivors participated. ELIGIBILITY CRITERIA to be a breast cancer survivor, and to have completed surgery, chemotherapy, and/or radiotherapy up to 10 years before recruitment. EXCLUSION CRITERIA metastatic breast cancer, a breast reconstruction intervention planned within 6 months, any absolute contraindication for exercise, to perform more than 300 minutes/week of structured exercise. INTERVENTIONS Participants were randomized to an exercise group (12-week resistance training program) or a control group. MAIN OUTCOME MEASURES Between-arms volume difference, shoulder-arm disabilities, and upper-limb muscular strength were evaluated at baseline and at week 12. Treatment-related information was registered from medical history. RESULTS No between-group differences were observed on between-arms volume difference (1.207; 95% CI -0.964, 3.377; P=.270) or shoulder-arm disabilities (2.070; 95% CI -4.362, 8.501; P=.521) after the training program. Likewise, there was no association of surgery type, presence of lymph node resection, chemotherapy, radiotherapy, and hormone therapy with the changes in between-arms volume and perceived shoulder-arm disabilities after the intervention. However, a higher increase in upper limb muscular strength was associated with a reduced shoulder-arm disabilities (-0.429; P=.020) in the exercise group. CONCLUSIONS The findings suggest that resistance training does not affect between-arms volume difference and shoulder-arm disabilities in female breast cancer survivors. The main risk factors for developing lymphedema were not associated with the effects of the intervention, although a higher increase in upper-limb muscular strength was associated with reduced shoulder-arm disabilities.
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Affiliation(s)
- Alba Esteban-Simón
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain; CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Centre, SPORT Research Group (CTS-1024), University of Almería, Almería, Spain.
| | - David M Díez-Fernández
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain; CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Centre, SPORT Research Group (CTS-1024), University of Almería, Almería, Spain
| | - Manuel A Rodríguez-Pérez
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain; CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Centre, SPORT Research Group (CTS-1024), University of Almería, Almería, Spain
| | - Eva Artés-Rodríguez
- Area of Statistics and Operative Research, Department of Mathematics, Faculty of Sciences, University of Almería, Almería, Spain
| | - Antonio J Casimiro-Andújar
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain; CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Centre, SPORT Research Group (CTS-1024), University of Almería, Almería, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain; CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Centre, SPORT Research Group (CTS-1024), University of Almería, Almería, Spain.
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2
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Wong SSS, Liu TW, Ng SSM. Performance of physical, cardiovascular, and psychological functions in middle-aged women with and without breast cancer. Eur J Oncol Nurs 2023; 66:102399. [PMID: 37689046 DOI: 10.1016/j.ejon.2023.102399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/08/2023] [Accepted: 07/15/2023] [Indexed: 09/11/2023]
Abstract
PURPOSE To compare the physical performance, including upper-limb motor and cardiovascular functions, and psychological functions, including anxiety and depression, sleep, and fatigue, between women with and without breast cancer. METHODS Thirty-two women with breast cancer and 32 healthy counterparts were recruited for the study. Upper-limb muscle strength, shoulder range of motion, and upper-limb function were assessed using a handheld dynamometer, a goniometer, and the short form of the Disabilities of Arm-Shoulder-Hand Questionnaire, respectively. Exercise endurance and cardiovascular functions were assessed using the 6-min walk test and blood pressure and heart rate variability, respectively. The Hospital Anxiety and Depression Scale, the Pittsburgh Sleep Quality Index, and the Fatigue Assessment Scale were used to assess the symptoms of anxiety and depression, sleep quality, and fatigue, respectively. RESULTS Breast cancer participants' body-weight-adjusted upper-limb strength of both the affected and unaffected sides (0.11-0.14) was only 61.1-77.8% of those of the healthy participants (0.18). Their shoulder mobility of the affected side (flexion: 161.64°; abduction: 157.01°) were 94.2% (flexion) and 92.5% (abduction) of those of the healthy participants (flexion: 171.56°; abduction: 169.68°), respectively. Breast cancer participants had higher quickDASH mean score (19.53), HADS-A mean score (6.78), HADS-D mean score (4.72), global PSQI mean score (7.22) and FAS mean score (25.97) as well as shorter mean distance covered by 6 MWT (496.66 m) than those of the healthy participants. CONCLUSIONS Rehabilitative interventions, such as mind-body interventions and exercise training, target physical fitness and promote the psychological health of women with breast cancer are necessary.
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Affiliation(s)
- Sarah Suet Shan Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China; School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong (SAR), China
| | - Tai Wa Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong (SAR), China
| | - Shamay Sheung Mei Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China; Research Centre for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China.
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3
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Canales-Lachén E, Asunsolo Á, Manrique OJ, Blázquez J, Holguín P, Maldonado AA. The Use of Ultrasound Imaging for Upper Extremity Lymphedema after Breast Cancer: A Systematic Review. J Reconstr Microsurg 2023; 39:102-110. [PMID: 36162421 DOI: 10.1055/s-0042-1750824] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND The aim of this study was to analyze the different applications of ultrasound (US) in upper extremity lymphedema (UEL) after breast cancer. METHODS A systematic review of the literature was performed in line with the PRISMA statement using MEDLINE/PubMed databases from January 1970 to December 2021. Articles describing the application of US in patients with UEL after breast cancer were included. The quality of the study, the level of reproducibility, and the different applications and type of US technique were analyzed. RESULTS In total, 30 articles with 1,193 patients were included in the final review. Five different applications were found: (1) diagnosis of UEL (14 studies found a direct correlation between lymphedema and morphological and/or functional parameters); (2) staging/severity of UEL (9 studies found a direct correlation between the clinical stage and the soft-tissue stiffness/texture/thickness); (3) therapeutic assessment (3 studies found an improvement in the circulatory status or in the muscle/subcutaneous thickness after conservative treatments); (4) prognosis assessment of UEL (1 study found a correlation between the venous flow and the risk of UEL); and (5) surgical planning (3 studies determined the location of the lymphatic vessel for lymphovenous anastomosis [LVA] surgery). CONCLUSION Morphological and functional parameters have been correlated with the diagnosis, stage, therapeutic effect, prognosis of UEL, and surgical planning of LVA.
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Affiliation(s)
| | - Ángel Asunsolo
- Department of Surgery, Medical and Social Science, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.,Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Oscar J Manrique
- Deparment of Plastic Surgery, University of Rochester Medical Center, Rochester, New York
| | - Javier Blázquez
- Department of Radiology, University Hospital Ramón y Cajal, Madrid, Spain.,Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | | | - Andrés A Maldonado
- Department of Surgery, Medical and Social Science, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.,Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain.,Department of Plastic Surgery, University Hospital Getafe, Madrid, Spain.,Department of Plastic, Hand and Reconstructive Surgery, BG Trauma Center Frankfurt am Main, Academic Hospital of the Goethe University Frankfurt am Main, Frankfurt am Main, Germany
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4
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Hayes SC, Singh B, Reul-Hirche H, Bloomquist K, Johansson K, Jönsson C, Plinsinga ML. The Effect of Exercise for the Prevention and Treatment of Cancer-Related Lymphedema: A Systematic Review with Meta-analysis. Med Sci Sports Exerc 2022; 54:1389-1399. [PMID: 35320145 DOI: 10.1249/mss.0000000000002918] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The purpose of this systematic review and meta-analysis was to evaluate the effects of exercise on (i) the prevention of cancer-related lymphedema (CRL) and (ii) the treatment of CRL, lymphedema-associated symptoms, and other health outcomes among individuals with CRL. METHODS An electronic search was undertaken for exercise studies measuring lymphedema and involving individuals at risk of developing or with CRL. The Effective Public Health Practice Project Quality scale was used to assess study quality, and overall quality of evidence was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. Meta-analyses were performed to evaluate effects of exercise on CRL incidence, existing CRL status, lymphedema-associated symptoms, and health outcomes. RESULTS Twelve studies ( n = 1955; 75% moderate-high quality) and 36 studies ( n = 1741; 58% moderate-high quality) were included in the prevention and treatment aim, respectively. Relative risk of developing CRL for those in the exercise group compared with the nonexercise group was 0.90 (95% confidence interval (CI), 0.72 to 1.13) overall and 0.49 (95% CI, 0.28 to 0.85) for those with five or more lymph nodes removed. For those with CRL in the exercise group, the standardized mean difference (SMD) before to after exercise of CRL was -0.11 (95% CI, -0.22 to 0.01), and compared with usual care postintervention, the SMD was -0.10 (95% CI, -0.24 to 0.04). Improvements after intervention were observed for pain, upper-body function and strength, lower-body strength, fatigue, and quality of life for those in the exercise group (SMD, 0.3-0.8; P < 0.05). CONCLUSIONS Findings support the application of exercise guidelines for the wider cancer population to those with or at risk of CRL. This includes promotion of aerobic and resistance exercise, and not just resistance exercise alone, as well as unsupervised exercise guided by symptom response.
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Affiliation(s)
| | - Ben Singh
- UniSA Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, AUSTRALIA
| | | | - Kira Bloomquist
- University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Copenhagen, DENMARK
| | - Karin Johansson
- Department of Health Sciences, Lund University, Lund, SWEDEN
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Ren T, Rong S, Wang H, Dai Y, Gu E, Tan N, Qi Y. Effect of Chinese Traditional Wushu on Cancer-Related Fatigue, Sleep Quality and Upper Limb Dysfunction of Breast Cancer Survivors: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6879566. [PMID: 35342756 PMCID: PMC8942623 DOI: 10.1155/2022/6879566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/12/2022] [Accepted: 02/26/2022] [Indexed: 11/17/2022]
Abstract
Objective This study is aimed at evaluating the effect of Chinese traditional Wushu (CTW) on cancer-related fatigue (CRF), sleep quality, and upper limb dysfunction. Data Sources. We searched studies containing randomized controlled trials up to July 2021 in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang database, and China Biological Medicine on this topic. Methods A randomized controlled trial of CTW on major outcome indicators such as CRF, sleep quality, and upper limb dysfunction of breast cancer survivors. Study screening, data extraction, and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted with Stata 16.0 software. The quality of the evidence was assessed by the Cochrane Collaboration Risk of Bias (ROB2.0). Results Eighteen studies met the requirements for meta-analysis (n = 1331). We found that CTW has no obvious effect on improving breast cancer survivors' CRF (SMD = -0.733; P = 0.059; I 2 = 89.3%), but it can effectively improve their sleep quality (WMD = -2.266; P = 0.022; I 2 = 99.2%) and upper limb dysfunction (SMD = 1.262; P ≤ 0.001; I 2 = 88.5%). Conclusion Although more studies on this topic are needed to prove the effectiveness of this method, the results of our review show that CTW is significantly helpful for better sleep and upper limb dysfunction. But the effects on CRF will need to be confirmed further. Implications for Cancer Survivors. In the future intervention process, to verify the effectiveness of CTW on improving CRF for breast cancer survivors, it would be suggested to pay close attention to breast cancer survivors' response to exercise, achieve regular follow-up, strictly conduct the intervention scheme on the premise of ensuring absolute security, and reduce the loss of intervention objects.
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Affiliation(s)
- Tuo Ren
- Sports and Art Institute, Hunan University of Chinese Medicine, Changsha 410208, China
| | - Siyu Rong
- Sports and Art Institute, Hunan University of Chinese Medicine, Changsha 410208, China
| | - Haonan Wang
- Department of Physical Education and Research, Central South University, 932 Lushan South Rd., Changsha 410083, China
| | - Yinghong Dai
- Xiangya School of Medicine, Central South University, No. 172 Tongzipo Road, Changsha Hunan 410013, China
| | - Erya Gu
- School of Foreign Languages, Central South University, 932 Lushan South Rd., Changsha 410083, China
| | - Na Tan
- Department of Physical Education and Research, Central South University, 932 Lushan South Rd., Changsha 410083, China
| | - Yufei Qi
- Department of Physical Education and Research, Central South University, 932 Lushan South Rd., Changsha 410083, China
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6
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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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Soriano-Maldonado A, Carrera-Ruiz Á, Díez-Fernández DM, Esteban-Simón A, Maldonado-Quesada M, Moreno-Poza N, García-Martínez MDM, Alcaraz-García C, Vázquez-Sousa R, Moreno-Martos H, Toro-de-Federico A, Hachem-Salas N, Artés-Rodríguez E, Rodríguez-Pérez MA, Casimiro-Andújar AJ. Effects of a 12-week resistance and aerobic exercise program on muscular strength and quality of life in breast cancer survivors: Study protocol for the EFICAN randomized controlled trial. Medicine (Baltimore) 2019; 98:e17625. [PMID: 31689771 PMCID: PMC6946307 DOI: 10.1097/md.0000000000017625] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The number of people living with the side effects of breast cancer treatment (eg, loss of muscular mass and muscular strength, upper-limb mobility and disability, lymphedema, cardiac toxicity, and reduced quality of life) is increasing yearly. These consequences can be improved through exercise, specially combining resistance and aerobic training. Previous exercise trials have not been consistent in applying training principles and standardized reporting, and this partly explains the variability in obtained results. The aim of this study is to assess the effect of a 12-week supervised resistance exercise program combined with home-based aerobic exercise, compared with home-based aerobic exercise only, on muscular strength and several aspects of health-related quality of life in breast cancer survivors. To maximize transparency, replicability, and clinical applicability, the intervention is described following the consensus on exercise reporting template. METHODS This study is a parallel-group randomized controlled trial in which 60 female breast cancer survivors, who have completed central treatments of the disease in the last 5 years, will be randomly assigned to either an experimental group that will perform a total of 24 progressive resistance training sessions for 12 weeks (ie, 2 weeks of individual training and 10 weeks of micro-group training) and will be requested to undertake 10,000 steps/d, or a control group that will be requested to undertake 10,000 steps/d, only. Outcomes will be evaluated at baseline and at week 12. Primary outcome measure is peak isometric muscular strength of the lower- and upper-body, assessed with several exercises through an electromechanical dynamometer. Secondary outcomes include cardiorespiratory fitness, upper-joint mobility and disability, health-related quality of life, cancer-related fatigue, depression, life satisfaction, and presence of lymphedema. DISCUSSION This study aims to investigate the extent to which a 12-week supervised and progressive resistance exercise program, in addition to home-based aerobic physical activity, might improve muscular strength and health-related quality of life in breast cancer survivors. The comprehensive description of the intervention will likely contribute to enhancing exercise prescription in this population. TRIAL REGISTRATION NUMBER ISRCTN14601208.
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Affiliation(s)
- Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences
- SPORT Research Group (CTS-1024), CERNEP Research Centre, University of Almería
| | | | - David M. Díez-Fernández
- Department of Education, Faculty of Education Sciences
- SPORT Research Group (CTS-1024), CERNEP Research Centre, University of Almería
| | | | | | | | | | | | - Rosa Vázquez-Sousa
- Hospital Universitario Torrecárdenas, Servicio de Radiodiagnóstico, Unidad de Mama, Almería, Spain
| | | | | | - Nur Hachem-Salas
- Servicio Andaluz de Salud, Unidad de Gestión Clínica Mediterráneo-Torrecárdenas, Distrito Sanitario
| | - Eva Artés-Rodríguez
- Area of Statistics and Operative Research, Department of Mathematics, Faculty of Sciences, University of Almería, Almería, Spain
| | - Manuel A. Rodríguez-Pérez
- Department of Education, Faculty of Education Sciences
- SPORT Research Group (CTS-1024), CERNEP Research Centre, University of Almería
| | - Antonio J. Casimiro-Andújar
- Department of Education, Faculty of Education Sciences
- SPORT Research Group (CTS-1024), CERNEP Research Centre, University of Almería
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Yilmaz Gokmen G, Akkoyunlu ME, Kilic L, Algun C. The Effect ofT'ai ChiandQigongTraining on Patients with Obstructive Sleep Apnea: A Randomized Controlled Study. J Altern Complement Med 2019; 25:317-325. [DOI: 10.1089/acm.2018.0197] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Gulhan Yilmaz Gokmen
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Bandirma, Turkey
| | - Muhammed Emin Akkoyunlu
- Sleep Disorders Center, Department of Pulmonology, Medical School, Bezmialem Vakif University, Istanbul, Turkey
| | - Lutfiye Kilic
- Pulmonary Rehabilitation Center, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Candan Algun
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Medipol University, Istanbul, Turkey
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9
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Levett-Jones T, Jones M. Physical activity for women diagnosed with breast cancer after adjuvant therapy: A Cochrane review summary. Int J Nurs Stud 2018; 103:103239. [PMID: 30579566 DOI: 10.1016/j.ijnurstu.2018.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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10
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Tackling the diversity of breast cancer related lymphedema: Perspectives on diagnosis, risk assessment, and clinical management. Breast 2018; 44:15-23. [PMID: 30580170 DOI: 10.1016/j.breast.2018.12.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/06/2018] [Accepted: 12/17/2018] [Indexed: 01/20/2023] Open
Abstract
Breast cancer related lymphedema (BCRL) develops as a consequence of surgical treatment and/or radiation therapy in a significant number of breast cancer patients. The etiology of this condition is multifactorial and has not yet been completely elucidated. Risk factors include high body mass index, radical surgical procedures (i.e. mastectomy and axillary lymph node dissection), number of lymph nodes removed and number of metastatic lymph nodes, as well as nodal radiation, and chemotherapy. However, these predisposing factors explain only partially the BCRL occurrence, suggesting the possible involvement of individual determinants. Despite the implementation of conservative approaches, BCRL still remains in a proportion of cases an incurable and progressive condition with major physical and psychological implications. To date, diagnostic methods and staging systems lack uniformity, leading to a possible underestimation of the real incidence of this condition, decreasing early detection and thus the possibility of an effective treatment. Several preventive and therapeutic options are available, both conservative and surgical, but are not included in a standardized intervention protocol, tailored on patient's specific characteristics. In this review, we provide a comprehensive overview of the current state-of-knowledge of BCRL management, novel advantages in the assessment of pre-operative evaluation and risk prediction and discuss strengths and weaknesses of diagnostic and treatment strategies currently accessible in clinical practice.
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11
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Guo Y, Xu MM, Huang Y, Ji M, Wei Z, Zhang J, Hu Q, Yan J, Chen Y, Lyu J, Shao X, Wang Y, Guo J, Wei Y. Safety of Qigong: Protocol for an overview of systematic reviews. Medicine (Baltimore) 2018; 97:e13042. [PMID: 30383671 PMCID: PMC6221731 DOI: 10.1097/md.0000000000013042] [Citation(s) in RCA: 6] [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] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Qigong, as one of the essential elements of Traditional Chinese exercises, has been used to improve physical and psychological health and combat diseases in China for thousands of years. In recent years, the beneficial effects of Qigong on different medical conditions are becoming more accepted by both patients and health care providers. Although it is a common impression that Qigong and related therapies are generally safe procedures, but the current understanding of its adverse events is fragmented. Thus, we conducted this overview to synthesize comprehensively existing systematic reviews on adverse events associated with Qigong and related therapies, and our findings can be used to informing clinicians, Qigong practitioner, and patients alike on applying such treatments or interventions in clinical treatment and daily life training mindful manner, and provide a guideline for researchers in future. METHODS A systematic review of reviews will be performed. A literature search strategy designed by a number of specialists in the fields of Traditional Chinese Medicine (TCM), sports medicine, health information, and Qigong training will be carried out in relevant English and Chinese electronic database. The date range of search will start from inception to the search date. Two reviewers will identify relevant studies, extract data information, and then assess the methodical quality by Assessment of Multiple Systematic Reviews (AMSTAR) tool. Any types of systematic review that summarized adverse effects related to Qigong and related therapies in human will be included. Any safety-related outcomes will be considered as the primary outcomes of this overview. Where objectives from 2 or more reviews overlap, we will assess the causes of any noted discrepancies between reviews. An overall summary of results will be performed using tabular and graphical approaches and will be supplemented by narrative description. RESULTS This overview will identify any adverse events associated with nonstandardized Qigong and related therapies procedures based on current relevant literature evidence of safety for Qigong. CONCLUSION Our overview will provide evidence to help synthesize the broad degree of information available on furthering the knowledge, safety, and application of Qigong. ETHICS AND DISSEMINATION Formal ethical approval is not required, as this study is an overview based on the published systematic reviews. The result of this overview of systematic reviews will be published in a peer-reviewed journal or disseminated at national and international conferences. PROSPERO REGISTRATION NUMBER PROSPERO CRD42018109409.
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Affiliation(s)
- Yu Guo
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
- Ovation Health Science and Technology Co. Ltd, ENN Group, Langfang
| | - Mingmin M. Xu
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Yuchang Huang
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
| | - Meiqi Ji
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
| | - Zeren Wei
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
| | - Jialei Zhang
- Ovation Health Science and Technology Co. Ltd, ENN Group, Langfang
| | - Qingchuan Hu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
- Ovation Health Science and Technology Co. Ltd, ENN Group, Langfang
| | - Jian Yan
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
- Ovation Health Science and Technology Co. Ltd, ENN Group, Langfang
| | - Yue Chen
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
- Ovation Health Science and Technology Co. Ltd, ENN Group, Langfang
| | - Jiaxuan Lyu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
| | - Xiaoqian Shao
- Ovation Health Science and Technology Co. Ltd, ENN Group, Langfang
| | - Ying Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
| | - Jiamei Guo
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
| | - Yulong Wei
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
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Sierla R, Dylke ES, Kilbreath S. A Systematic Review of the Outcomes Used to Assess Upper Body Lymphedema. Cancer Invest 2018; 36:458-473. [PMID: 30289283 DOI: 10.1080/07357907.2018.1517362] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE To ascertain how change in upper body lymphedema is assessed and understand how clinically significant change is determined. METHOD A systematic search of the literature resulted in 55 eligible studies for analysis. RESULTS A range of assessment methods, measurement protocols, and outcomes were used in the literature. Of the 21 studies in which thresholds for change were set a priori, 20 different thresholds were reported. CONCLUSION How data was measured, analysed and reported was inconsistent across studies. Consensus on a core outcome set with standardised assessment protocols and reporting; and investigation into empirically based minimum important differences (MID) is needed.
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Affiliation(s)
- Robyn Sierla
- a Faculty of Health Sciences , University of Sydney , Sydeny , Australia.,b Occupational Therapy Department , Royal Prince Alfred Hospital , Sydney , Australia
| | - Elizabeth Sian Dylke
- c Discipline of Physiotherapy, Faculty of Health Sciences , University of Sydney , Sydney , Australia
| | - Sharon Kilbreath
- d Faculty of Health Sciences , University of Sydney , Sydney , Australia
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Guo Y, Xu M, Zhang J, Hu Q, Zhou Z, Wei Z, Yan J, Chen Y, Lyu J, Shao X, Wang Y, Guo J, Wei Y. The effect of Three-Circle Post Standing (Zhanzhuang) Qigong on the physical and psychological well-being of college students: Study protocol for a randomized controlled trial. Medicine (Baltimore) 2018; 97:e12323. [PMID: 30235685 PMCID: PMC6160034 DOI: 10.1097/md.0000000000012323] [Citation(s) in RCA: 4] [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: 11/26/2022] Open
Abstract
BACKGROUND The physical and mental health of college students tends to continuously decline around the world due to lifestyle or behavior habits changes, and pervasive presence of the Internet. Thus it is urgent to improve their health in college life. As a traditional Qigong form is practiced mainly in a standing posture. Three-Circle Post Standing Qigong (TCPSQ) is suitable for regular practicing and has beneficial effects on improving the physiological function and psychological emotion by adjusting body, breathing, and mind. The aim of the 3 adjustments is to achieve a state of harmonious unity-integrating these adjustments into "one." In this study protocol article, we will systematically explore the effectiveness and safety, feasibility of TCPSQ on physical and psychological outcomes of the college students and deeply understand the state of harmonious unity-integrating adjustments of body, breath, and mind into "one." METHOD/DESIGN We will conduct a randomized, assessor, and statistician blinded, parallel-controlled trial comparing the beneficial effect of TCPSQ in college students. A total of 80 eligible college students from the Beijing University of Chinese Medicine (BUCM) will be recruited and randomly allocated into TCPSQ training or unaltered lifestyle control group according 1:1 allocation ratio with allocation concealment. TCPSQ intervention will last 10 weeks. The study period is 18 weeks including a 10-week supervised intervention and a 8-week follow-up. The relevant physical and psychological outcomes, adverse events, and safety will be evaluated at baseline, 6 weeks (at the mid-point of intervention), 11 weeks (at the end of intervention), and 19 weeks (after the 8-week follow-up period) by blinded independent outcome assessors. DISCUSSION This is the first randomized controlled trial protocol from the perspective of Qigong connotation to systematically investigate the effect of TCPSQ for the physical and mental health of a college student population. If the results in our study prove a significant intervention effect, this would provide preliminary higher-quality evidence and establish an optimal guidance for the application of TCPSQ exercise program among a college student population. ETHICS AND DISSEMINATION The study was approved by the ethics committee of the Beijing University of Chinese Medicine (approval number: 2018BZHYLL0109). A SPIRIT checklist is available for this protocol. The trial was registered in Chinese Clinical Trial Registry (WHO ICTRP member). Registration number: ChiCTR-BON-17010840.
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Affiliation(s)
- Yu Guo
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
- Ovation Health Science and Technology Co. Ltd, ENN Group, Langfang
| | - Mingmin Xu
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Jialei Zhang
- Ovation Health Science and Technology Co. Ltd, ENN Group, Langfang
| | - Qingchuan Hu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
- Ovation Health Science and Technology Co. Ltd, ENN Group, Langfang
| | - Zhengkun Zhou
- International Liaison Department, World Federation of Chinese Medicine Societies, Beijing, China
| | - Zeren Wei
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
| | - Jian Yan
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
- Ovation Health Science and Technology Co. Ltd, ENN Group, Langfang
| | - Yue Chen
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
- Ovation Health Science and Technology Co. Ltd, ENN Group, Langfang
| | - Jianxuan Lyu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
| | - Xiaoqian Shao
- Ovation Health Science and Technology Co. Ltd, ENN Group, Langfang
| | - Ying Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
| | - Jiamei Guo
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
| | - Yulong Wei
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing
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The Effect of Uncertainty Management Program on Quality of Life Among Vietnamese Women at 3 Weeks Postmastectomy. Cancer Nurs 2018; 42:261-270. [PMID: 29746263 DOI: 10.1097/ncc.0000000000000597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND In Vietnam, breast cancer is a top contributor to cancer-related deaths in women. Evidence shows that, after mastectomy, women in Vietnam have a lower quality of life than women in other countries. In addition, high uncertainty is a predictor of low quality of life postmastectomy. Therefore, if nurses can manage uncertainty, the quality of life postmastectomy can improve. OBJECTIVE This study examined the effect of the Uncertainty Management Program (UMP) on quality of life at 3 weeks postmastectomy in Vietnamese women. METHODS This research was a quasi-experimental study using a "posttest only with control group" design. There were 115 subjects assigned to either the experimental group (n = 57), who participated in the UMP and routine care, or the control group (n = 58), who received only routine care. Participants were assessed 2 times postmastectomy using the modified Quality of Life Index Scale-Vietnamese version. RESULTS The experimental group exhibited low uncertainty before discharge and significantly higher quality of life than the control group at 1 and 3 weeks postmastectomy, respectively (P < .05). Women's physical well-being, psychological well-being, body image concerns, and social concerns were significantly increased with UMP. CONCLUSION The UMP was considered as a promising program that might benefit the QoL of women with breast cancer 3 weeks postmastectomy. IMPLICATIONS FOR PRACTICE The UMP appears feasible to apply for women with breast cancer to improve their QoL postmastectomy in various settings. Nurses can flexibility instruct women in their holistic care attention both in the hospital and at home.
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Browning KK, Kue J, Lyons F, Overcash J. Feasibility of Mind-Body Movement Programs for Cancer Survivors. Oncol Nurs Forum 2018. [PMID: 28632239 DOI: 10.1188/17.onf.446-456] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To evaluate mind-body movement exercise (MBME) classes (yoga, tai chi, and Qigong) for cancer survivors.
. DESIGN A single-group, repeated-measures design.
. SETTING The Ohio State University Wexner Medical Center-Arthur G. James Cancer Hospital in Columbus.
. SAMPLE 33 adult cancer survivors, with any cancer diagnosis, participating in MBME classes.
. METHODS The researchers sought to examine feasibility of multiple data collection time points and data collection measures; acceptability; and changes to physical, emotional, and biometric measures over time, as a result of participation in MBME classes.
. MAIN RESEARCH VARIABLES Quality of life, sleep, depressive symptomatology, fatigue, stress, upper body strength, gait and balance, body mass index, heart rate, and blood pressure.
. FINDINGS The current study was feasible because survivors were willing to participate and completed most of the questionnaires. Participants found these classes to be beneficial not only for exercise, but also for social support and social connectedness. Poor sleep quality was consistently reported by participants. MBME classes should be recommended to survivors and are beneficial for oncology practices to offer.
. CONCLUSIONS Conducting MBME research with cancer survivors is feasible, and participants find the MBME acceptable and a way of addressing health and managing cancer-related symptoms.
. IMPLICATIONS FOR NURSING Nurses should help patients and caregivers identify locations and times when MBME class participation is possible, assess MBME class participation during each clinic visit to promote continued involvement and to understand if positive effects are occurring, and continue to provide support for MBME classes throughout the survivorship experience.
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Lahart IM, Metsios GS, Nevill AM, Carmichael AR. Physical activity for women with breast cancer after adjuvant therapy. Cochrane Database Syst Rev 2018; 1:CD011292. [PMID: 29376559 PMCID: PMC6491330 DOI: 10.1002/14651858.cd011292.pub2] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Women with a diagnosis of breast cancer may experience short- and long-term disease and treatment-related adverse physiological and psychosocial outcomes. These outcomes can negatively impact prognosis, health-related quality of life (HRQoL), and psychosocial and physical function. Physical activity may help to improve prognosis and may alleviate the adverse effects of adjuvant therapy. OBJECTIVES To assess effects of physical activity interventions after adjuvant therapy for women with breast cancer. SEARCH METHODS We searched the Cochrane Breast Cancer Group (CBCG) Specialised Registry, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Physiotherapy Evidence Database (PEDro), SPORTDiscus, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform, on 18 September 2015. We also searched OpenGrey and Healthcare Management Information Consortium databases. SELECTION CRITERIA We searched for randomised and quasi-randomised trials comparing physical activity interventions versus control (e.g. usual or standard care, no physical activity, no exercise, attention control, placebo) after adjuvant therapy (i.e. after completion of chemotherapy and/or radiation therapy, but not hormone therapy) in women with breast cancer. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, assessed risk of bias, and extracted data. We contacted trial authors to ask for additional information when needed. We calculated an overall effect size with 95% confidence intervals (CIs) for each outcome and used GRADE to assess the quality of evidence for the most important outcomes. MAIN RESULTS We included 63 trials that randomised 5761 women to a physical activity intervention (n = 3239) or to a control (n = 2524). The duration of interventions ranged from 4 to 24 months, with most lasting 8 or 12 weeks (37 studies). Twenty-eight studies included aerobic exercise only, 21 involved aerobic exercise and resistance training, and seven used resistance training only. Thirty studies described the comparison group as usual or standard care, no intervention, or control. One-fifth of studies reported at least 20% intervention attrition and the average physical activity adherence was approximately 77%.No data were available on effects of physical activity on breast cancer-related and all-cause mortality, or on breast cancer recurrence. Analysis of immediately postintervention follow-up values and change from baseline to end of intervention scores revealed that physical activity interventions resulted in significant small-to-moderate improvements in HRQoL (standardised mean difference (SMD) 0.39, 95% CI 0.21 to 0.57, 22 studies, 1996 women; SMD 0.78, 95% CI 0.39 to 1.17, 14 studies, 1459 women, respectively; low-quality evidence), emotional function (SMD 0.21, 95% CI 0.10 to 0.32, 26 studies, 2102 women, moderate-quality evidence; SMD 0.31, 95% CI 0.09 to 0.53, 15 studies, 1579 women, respectively; low-quality evidence), perceived physical function (SMD 0.33, 95% CI 0.18 to 0.49, 25 studies, 2129 women; SMD 0.60, 95% CI 0.23 to 0.97, 13 studies, 1433 women, respectively; moderate-quality evidence), anxiety (SMD -0.57, 95% CI -0.95 to -0.19, 7 studies, 326 women; SMD -0.37, 95% CI -0.63 to -0.12, 4 studies, 235 women, respectively; low-quality evidence), and cardiorespiratory fitness (SMD 0.44, 95% CI 0.30 to 0.58, 23 studies, 1265 women, moderate-quality evidence; SMD 0.83, 95% CI 0.40 to 1.27, 9 studies, 863 women, respectively; very low-quality evidence).Investigators reported few minor adverse events.Small improvements in physical activity interventions were sustained for three months or longer postintervention in fatigue (SMD -0.43, 95% CI -0.60 to -0.26; SMD -0.47, 95% CI -0.84 to -0.11, respectively), cardiorespiratory fitness (SMD 0.36, 95% CI 0.03 to 0.69; SMD 0.42, 95% CI 0.05 to 0.79, respectively), and self-reported physical activity (SMD 0.44, 95% CI 0.17 to 0.72; SMD 0.51, 95% CI 0.08 to 0.93, respectively) for both follow-up values and change from baseline scores.However, evidence of heterogeneity across trials was due to variation in intervention components (i.e. mode, frequency, intensity, duration of intervention and sessions) and measures used to assess outcomes. All trials reviewed were at high risk of performance bias, and most were also at high risk of detection, attrition, and selection bias. In light of the aforementioned issues, we determined that the evidence was of very low, low, or moderate quality. AUTHORS' CONCLUSIONS No conclusions regarding breast cancer-related and all-cause mortality or breast cancer recurrence were possible. However, physical activity interventions may have small-to-moderate beneficial effects on HRQoL, and on emotional or perceived physical and social function, anxiety, cardiorespiratory fitness, and self-reported and objectively measured physical activity. The positive results reported in the current review must be interpreted cautiously owing to very low-to-moderate quality of evidence, heterogeneity of interventions and outcome measures, imprecision of some estimates, and risk of bias in many trials. Future studies with low risk of bias are required to determine the optimal combination of physical activity modes, frequencies, intensities, and durations needed to improve specific outcomes among women who have undergone adjuvant therapy.
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Affiliation(s)
- Ian M Lahart
- University of WolverhamptonFaculty of Education, Health and WellbeingGorway RoadWalsallWest MidlandsUKWS1 3BD
| | - George S Metsios
- University of WolverhamptonFaculty of Education, Health and WellbeingGorway RoadWalsallWest MidlandsUKWS1 3BD
| | - Alan M Nevill
- University of WolverhamptonFaculty of Education, Health and WellbeingGorway RoadWalsallWest MidlandsUKWS1 3BD
| | - Amtul R Carmichael
- Queen's HospitalDepartment of SurgeryBelvedere RoadBurton on TrentStaffordshireUK
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Correlation Between Upper Limb Volume and Arterial and Venous Blood Flow Velocity in Lymphedema Secondary to Breast Cancer Treatment. J Manipulative Physiol Ther 2017; 40:241-245. [DOI: 10.1016/j.jmpt.2017.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 11/16/2015] [Accepted: 04/05/2016] [Indexed: 11/23/2022]
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Rezende MS, Marsengo AL, de Jesus Guirro RR, de Oliveira Guirro EC. Blood Flow Velocity in Brachial and Subclavian Vessels Immediately After Compressive Procedures for Treatment of Postcancer Therapy Lymphedema in Breast Cancer: A Randomized Blind Clinical Trial. Lymphat Res Biol 2017; 15:23-31. [PMID: 28278070 DOI: 10.1089/lrb.2016.0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study sought to evaluate the effect of elastic compression, functional compressive bandaging, and kinesiotherapy on blood flow of the upper limb with lymphedema secondary to the treatment of breast cancer. METHODS This was a randomized blind crossover clinical trial with a washout period of 7 days between treatments. We evaluated 20 women with a mean age of 66.85 years (standard deviation = 11.76), undergoing three types of therapeutic procedures randomly applied by lot: kinesiotherapy, functional compressive bandaging + kinesiotherapy (FCB), and elastic compression + kinesiotherapy (EC). Blood flow, including mean and maximum velocity, was assessed by Doppler ultrasound before and after the therapeutic procedure (immediately after, 15 minutes, and 30 minutes). We used two-way analysis of variance for repeated measures followed by Bonferroni's test, considering a significance level of 5%. RESULTS The EC and FCB groups showed a significant increase in the mean velocity of blood flow in the axillary and brachial arteries and veins compared to the group that received only kinesiotherapy (p < 0.05), but no difference between them (p > 0.05). Moreover, the EC and FCB groups showed greater increase in maximum velocity of blood flow in the brachial artery (p < 0.05) compared to the group that received only kinesiotherapy, but no difference between them (p > 0.05). CONCLUSION Elastic compression and functional compressive bandaging combined with kinesiotherapy increased blood flow of upper limb lymphedema.
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Affiliation(s)
- Monique Silva Rezende
- 1 Postgraduate Program in Rehabilitation and Functional Performance, Medical School of Ribeirão Preto, University of São Paulo , São Paulo, Brazil
| | - Ana Luiza Marsengo
- 2 Undergraduate Student, Medical School of Ribeirão Preto, University of São Paulo , São Paulo, Brazil
| | - Rinaldo Roberto de Jesus Guirro
- 1 Postgraduate Program in Rehabilitation and Functional Performance, Medical School of Ribeirão Preto, University of São Paulo , São Paulo, Brazil
| | - Elaine Caldeira de Oliveira Guirro
- 1 Postgraduate Program in Rehabilitation and Functional Performance, Medical School of Ribeirão Preto, University of São Paulo , São Paulo, Brazil
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Fong SSM, Choi AWM, Luk WS, Yam TTT, Leung JCY, Chung JWY. Bone Mineral Density, Balance Performance, Balance Self-Efficacy, and Falls in Breast Cancer Survivors With and Without Qigong Training: An Observational Study. Integr Cancer Ther 2017; 17:124-130. [PMID: 28050925 PMCID: PMC5950950 DOI: 10.1177/1534735416686687] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose: A deterioration in bone strength and balance performance
after breast cancer treatment can result in injurious falls. Therefore,
interventions need to be developed to improve the bone strength and balance
ability of breast cancer survivors. This cross-sectional exploratory study aimed
to compare the bone mineral density (BMD), balance performance, balance
self-efficacy, and number of falls between breast cancer survivors who practiced
qigong, breast cancer survivors who did not practice qigong, and healthy
individuals. Methods: The study included 40 breast cancer survivors
with more than 3 months of qigong experience, 17 breast cancer survivors with no
qigong experience, and 36 healthy controls. All the participants underwent
dual-energy X-ray absorptiometry scans to measure their lumbar spine, total hip,
femoral neck, and total radius BMDs. The participants also underwent a timed
one-leg stand test to measure their single-leg standing balance. The
participants’ balance self-efficacy was assessed using the activities-specific
balance confidence scale, and the number of falls experienced by each
participant was assessed in a face-to-face interview. Results: The
lumbar spine, total hip, femoral neck, and total radius BMDs were similar
between the 3 groups (P > .05). The breast cancer-qigong
group outperformed the breast cancer-control group by 27.3% when they performed
the one-leg stand test on a foam surface (P = .025), and they
also had a higher balance self-efficacy score (P = .006).
Nevertheless, the numbers of falls were comparable between the 3 groups
(P > .05). Conclusion: Qigong may be a
suitable exercise for improving the balance performance and balance
self-efficacy of breast cancer survivors.
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Affiliation(s)
| | - Anna W M Choi
- 2 Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
| | - W S Luk
- 3 Association of Licentiates of the Medical Council of Hong Kong, Hong Kong
| | - Timothy T T Yam
- 1 School of Public Health, University of Hong Kong, Hong Kong
| | - Joyce C Y Leung
- 1 School of Public Health, University of Hong Kong, Hong Kong.,4 Division of Nursing and Health Studies, Open University of Hong Kong, Hong Kong
| | - Joanne W Y Chung
- 5 Department of Health and Physical Education, Education University of Hong Kong, Hong Kong
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Satija A, Bhatnagar S. Complementary Therapies for Symptom Management in Cancer Patients. Indian J Palliat Care 2017; 23:468-479. [PMID: 29123357 PMCID: PMC5661353 DOI: 10.4103/ijpc.ijpc_100_17] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Cancer patients are often poly-symptomatic which distressingly affects their quality of lives (QOLs). Alhough, conventional management provides adequate symptom control, yet is coupled with some limitations. Complementary therapies (CTs) have shown beneficial effects in cancer patients for symptomatic relief. The aim of this article is to provide evidence-based review of commonly used CTs for symptom management in cancer care. Hypnosis has promising evidence to be used for managing symptoms such as pain, chemotherapy-induced nausea/vomiting, distress, fatigue, and hot flashes. Guided imagery increases comfort and can be used as a psycho-supportive therapy. Meditation substantially improves psychological function, mental health, and QOL. Cognitive behavioral therapies effectively reduce pain, distress, fatigue, anxiety, and depression; and improve subjective sleep outcomes along with mood and QOL. Yoga has short term beneficial effects for anxiety, depression, fatigue, perceived stress, QOL, and well-being. T'ai Chi and qigong are beneficial adjunctive therapies for supportive cancer care, but their role in reducing cancer pain is not well proven. Acupuncture is effective for reducing treatment related side-effects, pain and fatigue. Other therapies such as massage techniques, energy therapies, and spiritual interventions have also demonstrated positive role in managing cancer-related symptoms and improve overall well-being. However, the clinical effectiveness of these therapies for symptom management in cancer patients cannot be concluded due to poor strength of evidence. Nonetheless, these are relatively free from risks and hence can be given along with conventional treatments. Only by tailoring these therapies as per patient's beliefs and preferences, optimal patient-centered holistic care can be provided.
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Affiliation(s)
- Aanchal Satija
- Department of Onco-Anaesthesia and Palliative Medicine, Dr. BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sushma Bhatnagar
- Department of Onco-Anaesthesia and Palliative Medicine, Dr. BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Sustainable impact of an individualized exercise program on physical activity level and fatigue syndrome on breast cancer patients in two German rehabilitation centers. Support Care Cancer 2016; 25:1047-1054. [PMID: 27942857 DOI: 10.1007/s00520-016-3490-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 11/07/2016] [Indexed: 12/29/2022]
Abstract
PURPOSE Although physical activity has been demonstrated to increase cancer survival in epidemiological studies, breast cancer patients tend toward inactivity after treatment. METHODS Breast cancer patients were quasi-randomly allocated to two different groups, intervention (IG) and control (CG) groups. The intervention group (n = 111) received an individual 3-week exercise program with two additional 1-week inpatient stays after 4 and 8 months. At the end of the rehabilitation, a home-based exercise program was designed. The control group (n = 83) received a 3-week rehabilitation program and did not obtain any follow-up care. Patients from both groups were measured using questionnaires on physical activity, fatigue, and quality of life (QoL) at five time points, 4 months (t1), 8 months (t2), 12 months (t3), 18 months (t4), and 24 months (t5) after the beginning of the rehabilitation. RESULTS After 2 years, the level of physical activity (total metabolic rate) increased significantly from 2733.16 ± 2547.95 (t0) to 4169.71 ± 3492.27 (t5) metabolic equivalent (MET)-min/week in the intervention group, but just slightly changed from 2858.38 ± 2393.79 (t0) to 2875.74 ± 2590.15 (t5) MET-min/week in the control group (means ± standard deviation). Furthermore, the internal group comparison showed significant differences after 2 years as well. These results came along with a significantly reduced fatigue syndrome and an increased health-related quality of life. CONCLUSIONS The data indicate that an individual, according to their preferences, and physical-resource-adapted exercise program has a more sustainable impact on the physical activity level in breast cancer patients than the usual care. It is suggested that the rehabilitation program should be personalized for all breast cancer patients.
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Effects of non-sporting and sporting qigong on frailty and quality of life among breast cancer patients receiving chemotherapy. Eur J Oncol Nurs 2016; 21:257-65. [DOI: 10.1016/j.ejon.2015.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 09/16/2015] [Accepted: 10/30/2015] [Indexed: 11/18/2022]
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Singh B, Disipio T, Peake J, Hayes SC. Systematic Review and Meta-Analysis of the Effects of Exercise for Those With Cancer-Related Lymphedema. Arch Phys Med Rehabil 2016; 97:302-315.e13. [DOI: 10.1016/j.apmr.2015.09.012] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 09/07/2015] [Accepted: 09/11/2015] [Indexed: 11/28/2022]
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Gaydarova AH, Kotenko NV, Manzhosova MI, Gigineishvili GR. Modern possibilities of medical rehabilitation of patients after breast cancer (a review). ACTA ACUST UNITED AC 2016. [DOI: 10.17116/repro201622618-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Meditative qigong relieved symptom severity and interference among patients with breast carcinoma receiving chemotherapy. Eur J Integr Med 2015. [DOI: 10.1016/j.eujim.2015.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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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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Fu MR, Deng J, Armer JM. Putting evidence into practice: cancer-related lymphedema. Clin J Oncol Nurs 2015; 18 Suppl:68-79. [PMID: 25427610 DOI: 10.1188/14.cjon.s3.68-79] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cancer-related lymphedema is a progressive and chronic syndrome of abnormal swelling and multiple symptoms resulting from cancer treatment. Even with modern medical advances, lymphedema remains a major health problem affecting thousands of cancer survivors. To provide healthcare professionals with evidence-based clinical practice guidelines for lymphedema treatment and management, a systematic review was conducted to evaluate 75 selected articles from 2009-2014 by the Oncology Nursing Society Putting Evidence Into Practice lymphedema team. Findings of the systematic review support complete decongestive therapy, compression bandages, and compression garments with highest evidence for best clinical practice. Weight management, full-body exercise, information provision, prevention, and early intervention protocols are likely to be effective for clinical practice. Historic recommendations for activity restriction and avoidance of aerobic and resistive exercises that limit cancer survivors' daily lives have been challenged with more evidence. Cancer survivors may not need to restrict activities such as resistive or aerobic exercises and weightlifting with gradual exercise progression. Future research should focus on providing high-level evidence using randomized clinical trials with larger samples and studying lymphedema beyond breast cancer.
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Affiliation(s)
- Mei R Fu
- College of Nursing, New York University, New York
| | - Jie Deng
- School of Nursing, Vanderbilt University, Nashville, TN
| | - Jane M Armer
- School of Nursing, University of Missouri, Columbia
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28
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Kim S, Lee S, Kwon O, Park S, Seo J, Kim K. Qigong program on insomnia and stress in cancer patients: A case series report. SAGE Open Med Case Rep 2015; 3:2050313X14556408. [PMID: 27489671 PMCID: PMC4857300 DOI: 10.1177/2050313x14556408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 08/18/2014] [Indexed: 11/15/2022] Open
Abstract
Background: In recent years, the interest in Qigong as an alternative therapy has grown following reports of its ability to regulate psychological factors in cancer patients. This is a case series to evaluate the outcome measures of Qigong when used as an adjunct to standard medical care to treat insomnia and stress in cancer patients. Patients and methods: The Qigong program was applied to four cancer patients with insomnia, stress, and anxiety. The program consisted of 30-min sessions involving exercise, patting of the 12 meridians, and spontaneous breathing exercises three times a week for a period of 4 weeks. The Pittsburgh Sleep Quality Index was measured as the primary outcome, while the Stress Scale, the State–Trait Anxiety Inventory, and the Functional Assessment Cancer Therapy–General determined the secondary outcomes. Insomnia, stress, and anxiety levels were examined weekly, while quality of life was examined on the first visit and the last visit. Results: The Pittsburgh Sleep Quality Index and Stress Scale scores were reduced after conduct of the Qigong program. Conclusion: This study could provide a better understanding of Qigong’s influence on insomnia and stress in cancer patients. However, a larger controlled trial should be conducted to confirm these findings.
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Affiliation(s)
- Seungmo Kim
- Department of Internal Medicine, College of Korean Medicine, Daegu Haany University, Daegu, Korea
| | - Sangnam Lee
- Department of Qigong, College of Korean Medicine, Daegu Haany University, Daegu, Korea
| | - Osung Kwon
- Department of Medical Statistics, School of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Seonghoon Park
- Comprehensive and Integrative Medicine Institute, Daegu, Korea
| | - Jungchul Seo
- Comprehensive and Integrative Medicine Institute, Daegu, Korea
| | - Kyungsoon Kim
- Department of Internal Medicine, College of Korean Medicine, Daegu Haany University, Daegu, Korea
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29
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Abstract
Being diagnosed with a life-threatening disease such as cancer and undergoing treatment can cause unwanted distress and interferes with quality of life. Uncontrolled stress can have a negative effect on a number of biological systems and processes leading to negative health outcomes. While some distress is normal, it is not benign and must be addressed, as failure to do so may compromise health and QOL outcomes. We present the evidence for the role of stress in cancer biology and mechanisms demonstrating how distress is associated with worse clinical outcomes. The National Comprehensive Cancer Network states that all patients be screened with the single-item distress thermometer and to also indicate the source of distress and to get appropriate referral. In addition to the many conventional approaches for managing distress from the fields of psychology and psychiatry, many patients are seeking strategies to manage their distress that are outside conventional medicine such as mind-body techniques. Mind-body techniques such as meditation, yoga, tai chi, and qigong have been found to lower distress and lead to improvements in different aspects of quality of life. It is essential that the standard of care in oncology include distress screening and the delivery of different techniques to help patients manage the psychosocial challenges of diagnosis and treatment of cancer.
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Affiliation(s)
- Alejandro Chaoul
- Department of General Oncology, Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kathrin Milbury
- Department of General Oncology, Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Anil K. Sood
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sarah Prinsloo
- Department of General Oncology, Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lorenzo Cohen
- Department of General Oncology, Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX,Corresponding Author: ; Tel: 713-745-4260; Fax: 713-745-2437
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30
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Fong SSM, Ng SSM, Lee HW, Pang MYC, Luk WS, Chung JWY, Wong JYH, Masters RSW. The Effects of a 6-Month Tai Chi Qigong Training Program on Temporomandibular, Cervical, and Shoulder Joint Mobility and Sleep Problems in Nasopharyngeal Cancer Survivors. Integr Cancer Ther 2014; 14:16-25. [DOI: 10.1177/1534735414556508] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Introduction. Nasopharyngeal cancer (NPC) survivors often sustain head–neck–shoulder impairments from conventional treatments, which could disturb sleep. This novel study aimed to examine the efficacy of Tai Chi (TC) Qigong in optimizing temporomandibular joint (TMJ), cervical, and shoulder joint mobility and reducing sleep problems in NPC survivors. Methods. Fifty-two NPC survivors participated in the study. The experimental group (n = 25) received 6 months of TC Qigong training (1.5 h/session; 4 sessions/wk including self-practice) while the control group (n = 27) received no training. Cervical side flexion and rotation, shoulder flexion and horizontal flexion range of motion (ROM), mouth opening capacity (interincisor distance), and sleep problems (Medical Outcomes Study Sleep Scale) were assessed at baseline, mid-intervention (3 months), immediately after TC Qigong training, and at 6-month follow-up. Results. Intention-to-treat analysis revealed improvement in cervical side flexion ROM only ( P < .008) and unchanged shoulder and TMJ mobility ( P > .008) after the TC Qigong training. Deterioration was observed in shoulder flexion ROM and mouth opening capacity in the no-training controls over time ( P < .008). Sleep problems also decreased in the TC Qigong group ( P < .008), and this effect was most profound during the follow-up period. In addition, improvement in cervical side flexion ROM was associated with a reduction in sleep problems in the experimental group after TC Qigong training ( P < .05). Conclusions. The 6-month TC Qigong intervention improved neck mobility, maintained TMJ and shoulder joint mobility, and reduced sleep problems for NPC survivors. TC Qigong could be an effective nonpharmacological intervention for managing progressive trismus, chronic neck and shoulder hypomobility, and reducing sleep problems among NPC survivors.
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Affiliation(s)
| | - Shamay S. M. Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - H. W. Lee
- Institute of Human Performance, The University of Hong Kong, Hong Kong
| | - Marco Y. C. Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - W. S. Luk
- The Association of Licentiates of the Medical Council of Hong Kong, Hong Kong
| | - Joanne W. Y. Chung
- Department of Health and Physical Education, Hong Kong Institute of Education, Hong Kong
| | - Janet Y. H. Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Rich S. W. Masters
- Institute of Human Performance, The University of Hong Kong, Hong Kong
- Department of Sport and Leisure Studies, University of Waikato, Hamilton, New Zealand
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31
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Fong SSM, Ng SSM, Luk WS, Chung JWY, Leung JCY, Masters RSW. Effects of a 6-month Tai Chi Qigong program on arterial hemodynamics and functional aerobic capacity in survivors of nasopharyngeal cancer. J Cancer Surviv 2014; 8:618-26. [PMID: 24908587 DOI: 10.1007/s11764-014-0372-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 05/23/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Shirley S M Fong
- Institute of Human Performance, University of Hong Kong, Pokfulam, Hong Kong, China,
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