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Sharma NK, Li H, Aoyagi K, Ritchey S, Mohr E, Burton DC, Arnold PM, Colgrove Y. Tailored Yoga Intervention for Postlumbar Spine Surgical Pain Management: A Feasibility Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:753-761. [PMID: 38513063 DOI: 10.1089/jicm.2023.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Introduction: Severe pain, anxiety, and high opioid use are common following lumbar spine surgery (LSS). Yoga helps to reduce pain and anxiety, but it has not been considered for postsurgical care. The authors developed and tested the feasibility of a tailored yoga program designed for individuals undergoing LSS and explored clinical feasibility of yoga intervention on measures of pain, function, psychological status, and opioid use. Methods: Individuals scheduled for LSS were randomized into yoga versus control groups presurgery. Participants in the yoga group received tailored yoga sessions plus usual care, whereas participants in the control group received usual care only during the hospital stay post-LSS. In-person daily yoga sessions were individually presented and performed in the participant's hospital room. Feasibility was assessed by recruitment and retention rates, rate of yoga session completion, tolerance to yoga intervention, and ability to carry out planned assessment. Exploratory clinical outcomes included pain, psychological measures, Timed-Up-and-Go test, gait distance, and opioid use, during the hospital stay post-LSS. Results: Forty-one participants were enrolled, of which 30 completed. There were no dropouts. Planned assessments were completed within 45 min, suggesting no excessive burden on participants. Baseline variables were similar across both groups. The majority of participants participated in yoga intervention on the day of surgery or one day after surgery with acceptance rate of 100%. Participants showed good tolerance to yoga intervention on 0-4 tolerance scale and by their reports of exploratory clinical outcomes. Conclusion: This study indicates feasibility for a modified yoga program for postoperative care following LSS due to participant tolerance and retention. The results provide preliminary framework for future confirmatory studies that can assess the potential benefits of yoga in reducing pain, catastrophizing behavior, and opioid use and improving function. A modified yoga program focusing on diaphragmatic breathing, relaxation, and core isometric contraction exercises can be an important adjunct intervention for patients undergoing LSS. CTR Number: This trial was registered in UMIN CTR (https://rctportal.niph.go.jp/en/) with registration number: UMIN000032595.
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Affiliation(s)
- Neena K Sharma
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Haiyin Li
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York, USA
- Department of Orthopedics, University of Rochester Medical Center, Rochester, New York, USA
| | - Kosaku Aoyagi
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Physical Therapy and Movement Science, College of Health Sciences, University of Texas at El Paso, El Paso, Texas, USA
| | - Shannon Ritchey
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Elisa Mohr
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Douglas C Burton
- Department of Orthopedic Surgery, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Paul M Arnold
- Department of Neurosurgery, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Yvonne Colgrove
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA
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Schechter T, Tardif-Theriault C, Culos-Reed N, Lewis V, Orsey A, Diorio C, Tomlinson GA, Sung L. Yoga versus iPad active control for fatigue in paediatric cancer therapy: a randomised controlled trial. BMJ Support Palliat Care 2023:spcare-2023-004609. [PMID: 38160047 DOI: 10.1136/spcare-2023-004609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/09/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES The primary objective was to determine if individualised yoga for hospitalised children receiving intensive chemotherapy was associated with less fatigue using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL MFS) compared with iPad control. METHODS This was a multicentre randomised controlled trial of individualised yoga in paediatric patients aged 8-18 years who were inpatients receiving intensive chemotherapy for leukaemia, lymphoma or haematopoietic cell transplantation. Participants were randomised to yoga or iPad groups; allocated programme was delivered individually by trained yoga instructors 5 days/week for 21 days. The primary outcome was day 21 guardian-reported general fatigue using the PedsQL MFS. Secondary outcomes included day 21 PedsQL sleep/rest and cognitive fatigue, Fatigue Scale and PedsQL Acute Cancer Module, and systemic opioid administration. RESULTS The study was closed early for poor accrual when 125/210 planned participants had been enrolled and randomised to yoga (n=62) or iPad (n=63). Guardian-reported PedsQL MFS general fatigue scores on day 21 were not significantly different between groups (adjusted difference 7.2, 95% CI -2.6 to 16.9) in favour of yoga. However, day 21 cognitive fatigue (adjusted difference 9.0, 95% CI 0.9 to 17.1), cognitive problems (adjusted difference 11.2, 95% CI 3.5 to 19.0) and communication (adjusted difference 10.6, 95% CI 0.8 to 20.4) were significantly better in the yoga compared with the iPad group. There were no significant differences in the other secondary outcomes including PedsQL sleep/rest fatigue (adjusted difference 4.9, 95% CI -3.5 to 13.3). CONCLUSIONS The effect of individualised yoga on general fatigue is uncertain in paediatric patients receiving intensive chemotherapy. However, yoga significantly improved cognitive fatigue and cognitive problems. TRIAL REGISTRATION NUMBER NCT02134782.
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Affiliation(s)
- Tal Schechter
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Victor Lewis
- University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Andrea Orsey
- Hematology Oncology, Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - Caroline Diorio
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - George A Tomlinson
- Department of Medicine, Toronto General Hospital, Toronto, Ontario, Canada
| | - Lillian Sung
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
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Physical Activity as a Treatment for Cancer-Related Fatigue in Children, Adolescents and Young Adults: A Systematic Review. CHILDREN 2023; 10:children10030572. [PMID: 36980130 PMCID: PMC10047895 DOI: 10.3390/children10030572] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/06/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023]
Abstract
Background: Cancer-related fatigue (CRF) is one of the most common and distressing symptoms in paediatric oncology. Based on previous studies, physical activity interventions are considered to be effective in reducing CRF in adult cancer patients. Aim: The aim of this systematic review is to investigate whether physical activity interventions can reduce CRF in paediatric patients undergoing cancer treatment. Methodology: A systematic literature search was conducted in PubMed and Sport-Discus in October 2021 to identify intervention studies examining the effects of physical activity on CRF in cancer patients ≤ 21 years of age. Their methodological quality was assessed using the JBI Critical Appraisal Tool. Results: A total of 20 studies (seven randomized-controlled, six quasi-experimental and seven single-arm intervention trials) were included in the review. Nine studies reported significant positive effects of physical activity interventions on CRF in group comparison or within groups. Eleven trials reported no significant changes in CRF. Conclusion: Physical activity as a therapeutic intervention in paediatric oncology may have the potential to reduce CRF in childhood cancer patients undergoing cancer treatment. Further high-quality studies with large samples are needed to verify these results and to assess the interdependence of dose and response of physical activity interventions.
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Rapti C, Dinas PC, Chryssanthopoulos C, Mila A, Philippou A. Effects of Exercise and Physical Activity Levels on Childhood Cancer: An Umbrella Review. Healthcare (Basel) 2023; 11:healthcare11060820. [PMID: 36981477 PMCID: PMC10048410 DOI: 10.3390/healthcare11060820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 03/14/2023] Open
Abstract
Patients and survivors of childhood cancer experience adverse effects related to the disease and its treatment. These adverse effects are associated with both physiological and psychological health. Exercise helps manage the side effects and improve the health outcomes. The objective of this umbrella review is to search the current literature in the context of exercise and physical activity as complementary interventions on pediatric cancer and to provide comprehensive information about the derived health outcomes. A literature search was conducted on the Cochrane, PubMed, and Embase databases for systematic reviews published up to January 2023. Moreover, a hand search of reference lists was performed. We included participants under 19 years of age at diagnosis of any type of childhood cancer, without restriction on the type or phase of treatment, who participated in exercise interventions. The results showed a beneficial impact on fatigue, muscle strength, aerobic capacity, activity and participation levels, psychosocial health, cardiovascular/cardiorespiratory fitness, physical function, bone mineral density, and brain volume and structure, with limited and not serious adverse effects. These findings documented that exercise interventions had a positive effect on many physiological and psychological health outcomes in pediatric cancer patients and survivors.
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Affiliation(s)
- Christina Rapti
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Petros C. Dinas
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Costas Chryssanthopoulos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Alexandra Mila
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
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Rossi F, Zucchetti G, Esposito M, Berchialla P, Sciannameo V, Vassallo E, Saglio F, Chamorro Viña C, Scarrone S, Vittorini R, Fagioli F. Rehabilitation in children and adolescents undergoing stem cell transplantation: A pilot study focused on motor performance. Eur J Cancer Care (Engl) 2022; 31:e13711. [PMID: 36168857 DOI: 10.1111/ecc.13711] [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: 12/28/2021] [Revised: 08/27/2022] [Accepted: 09/07/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this pilot trial is evaluating the preliminary effectiveness of two in-hospital interventions in the maintenance of motor performance in children/adolescents undergoing hematopoietic stem cell transplantation (HSCT). Secondary objectives investigated the interventions' feasibility, impact on fatigue and to what degree the subjects' maintained their ankle dorsiflexion range of movement (ROM), functional mobility, muscle strength and flexibility. METHODS This trial included 5- to 18-year-old participants, affected by oncological and non-oncological diseases during hospitalisation for autologous/allogenic HSCT. The subjects were assigned to an exercise group (EG), or a counselling group based on a cluster model based on inpatient timeframe. The EG subjects performed strengthening, stretching and aerobic exercises for 30 min/5 days a week. Both groups followed rehabilitation counselling indications (RCI), 7 days a week. RESULTS Forty-nine participants were enrolled (median age = 12.9 years) (EG n = 36). In both groups the participants maintained their baseline motor performance and ankle ROM, and the children/adolescents and parents reduced their levels of fatigue. However, the interventions were not effective in maintaining strength. CONCLUSION In maintaining the subjects' motor performance, the RCI results are significant because they pave the way for the application in clinical practice contexts where there are poor rehabilitation resources. Clinical Trials registration NCT03842735.
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Affiliation(s)
- Francesca Rossi
- Rehabilitation Service, Public Health and Pediatric Sciences Department, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Giulia Zucchetti
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | | | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Veronica Sciannameo
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Elena Vassallo
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Francesco Saglio
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Carolina Chamorro Viña
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Kids Cancer Care Foundation of Alberta, Calgary, Alberta, Canada
| | - Silvia Scarrone
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Roberta Vittorini
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Franca Fagioli
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
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Schmidt-Andersen P, Fridh MK, Müller KG, Anna Pouplier, Hjalgrim LL, Faigenbaum AD, Schmiegelow K, Hasle H, Lykkedegn S, Zhang H, Christensen J, Larsen HB. Integrative Neuromuscular Training in Adolescents and Children Treated for Cancer (INTERACT): Study Protocol for a Multicenter, Two-Arm Parallel-Group Randomized Controlled Superiority Trial. Front Pediatr 2022; 10:833850. [PMID: 35359909 PMCID: PMC8964065 DOI: 10.3389/fped.2022.833850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/14/2022] [Indexed: 12/19/2022] Open
Abstract
Background Improved survival rates for children and adolescents diagnosed with cancer call for novel strategies for reducing short- and long-term treatment-related side effects. These include the physical and metabolic sequelae that are exacerbated by sedentary behavior and treatment-induced toxicities. We aim to investigate the effect of an integrative neuromuscular training intervention during the first 6 months of anti-cancer treatment primarily on muscle strength, and secondarily on exercise capacity, physical function, markers of metabolic syndrome, dysmetabolism, and health-related quality of life during and after ended treatment. Methods One hundred and twenty-seven children and adolescents, newly diagnosed with malignant and benign neoplasia, aged 6-17 years, and treated with chemotherapy or radiation will be randomized to either the intervention or the control arm of the study. The intervention group will, in addition to usual care, be offered a combination of 6 months of supervised physical exercise (integrative neuromuscular training) and home-based exercise. The active control group will, in addition to usual care, receive information along an unsupervised written home-based training program. All participants, including parents, will receive information about the importance of physical exercise during the course of cancer treatment, at the start of treatment, and in 5 monthly sessions. The primary outcome is measured in terms of isometric quadriceps muscle strength. Secondary outcomes include muscle strength and endurance, markers of metabolic syndrome and dysmetabolism, exercise capacity, physical function and activity, days of hospitalization, and health-related quality of life. Assessment will be conducted at treatment initiation (baseline), at 3 and 6 months after inclusion, and 1 month and 1 year after ended treatment. The primary endpoint for lower-body muscle strength is at 6 months after treatment initiation. The effects of the intervention will be evaluated through a constrained linear mixed model. Discussion This national randomized controlled study has the potential to provide new knowledge concerning the short- and long-term effects of a novel, inclusive approach for youth exercise programming (integrative neuromuscular exercise) in children and adolescents during anti-cancer treatment. Using a pragmatic, low-cost, and time-efficient training design, this intervention can be easily adapted to both hospital and home settings. Clinical Trial Registration ClinicalTrials.gov (NCT04706676), first released January 5, 2021.
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Affiliation(s)
- Peter Schmidt-Andersen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Occupational and Physiotherapy, Center of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Klaus Gottlob Müller
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anna Pouplier
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lisa Lyngsie Hjalgrim
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Avery D. Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, United States
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Hasle
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Sine Lykkedegn
- Department of Pediatric Hematology and Oncology, H.C. Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - He Zhang
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational and Physiotherapy, Center of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Mora DC, Kristoffersen AE, Overvåg G, Jong MC, Mentink M, Liu J, Stub T. Safety of Complementary and Alternative Medicine (CAM) treatment among children and young adults who suffer from adverse effects of conventional cancer treatment: A systematic review. Integr Cancer Ther 2022; 21:15347354221105563. [PMID: 35726681 PMCID: PMC9218455 DOI: 10.1177/15347354221105563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/04/2022] [Accepted: 03/21/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Complementary and Alternative Medicine (CAM) is widely used around the world to treat adverse effects derived from cancer treatment among children and young adults. Parents often seek CAM to restore and maintain the child's physical and emotional condition during and after cancer treatment. OBJECTIVES The objectives of this review were (i) to identify literature that investigates CAM use for treating adverse effects of conventional cancer treatment, (ii) to investigate the safety of the included CAM modalities, and (iii) to evaluate the quality of included studies. METHODS Five scientific research databases were used to identify observational, quasi-experimental, and qualitative studies from January 1990 to May 2021. Included studies investigated the use of CAM to treat adverse effects of cancer treatment in childhood cancer. RESULTS Fifteen studies were included in this review. Ten quasi-experimental, 3 observational studies (longitudinal/prospective), 2 qualitative studies, and 1 study with a quasi-experimental and qualitative arm were identified. Less than half (n = 6; 40%) of the studies included reported adverse effects for the CAM modality being studied. Among the studies that reported adverse effects, they were mostly considered as direct risk, as 13% reported mainly bleeding and bruising upon acupuncture treatment, and dizziness with yoga treatment. All adverse effects were assessed as minor and transient. CAM modalities identified for treating adverse effects of cancer treatment were alternative medical systems, manipulative and body-based therapies, biologically-based therapies, and mind-body therapies. CAM modalities were used to alleviate anxiety, pain, toxicity, prevent trauma, and improve health-related quality of life, functional mobility, and physical activity levels. All studies assessed scored 70% or above according to the Joanna Briggs Institute critical appraisal for study quality checklists. CONCLUSION Most of the studies (58.3%) included in this review did not report adverse effects from CAM modalities used to treat adverse effects of cancer treatment in children and young adults. This lack of safety information is of concern because parents need to know whether the modality represents an extra burden or harm to the child. To improve awareness about safety in the field, a universal and uniform reporting system for adverse effects in CAM research is needed.
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Affiliation(s)
- Dana C. Mora
- UiT The Arctic University of Norway, Tromsø, Norway
| | | | | | - Miek C. Jong
- UiT The Arctic University of Norway, Tromsø, Norway
| | - Marit Mentink
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Jianping Liu
- Beijing University of Chinese Medicine and Pharmacology, Beijing, China
| | - Trine Stub
- UiT The Arctic University of Norway, Tromsø, Norway
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Stritter W, Everding J, Luchte J, Eggert A, Seifert G. Yoga, Meditation and Mindfulness in pediatric oncology - A review of literature. Complement Ther Med 2021; 63:102791. [PMID: 34808385 DOI: 10.1016/j.ctim.2021.102791] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Children and adolescents undergoing treatment for cancer are exposed to a wide variety of stressors both physical and mental. Not only adults but also children and adolescents increasingly practice yoga in a health-promoting manner and to cope with stressful situations. METHODS A review of literature was conducted to present the current outcomes on yoga, meditation and mindfulness for children and adolescents who are affected by an oncological disease. RESULTS Eight studies were identified that examined yoga treatment for children and adolescents with oncological diseases. Three studies were found on mindfulness in pediatric oncology. The studies summarized here suggest that yoga and mindfulness could help to improve quality of life, reduce fatigue, improve activity and fitness levels, improve sleep quality, increase appetite and decrease anxiety in various stages of the disease and its treatment. The reviewed studies showed that yoga and mindfulness-based interventions for children and adolescents with oncological illnesses are feasible in different settings and are well received. CONCLUSIONS The results of the studies suggest that yoga and mindfulness may help to support children and adolescents during and after oncological treatment. Based on the current body of evidence it is not possible to draw conclusions about the efficacy of yoga and mindfulness-based interventions in pediatric oncology patients. Research must meet this challenge to develop suitable designs to further and better investigate the effects of yoga and mindfulness in children and adolescents with oncological diseases.
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Affiliation(s)
- Wiebke Stritter
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatrics, Division of Oncology and Hematology, Charitéplatz 1, 10117 Berlin, Germany.
| | - Janina Everding
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatrics, Division of Oncology and Hematology, Charitéplatz 1, 10117 Berlin, Germany
| | - Jacqueline Luchte
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatrics, Division of Oncology and Hematology, Charitéplatz 1, 10117 Berlin, Germany
| | - Angelika Eggert
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatrics, Division of Oncology and Hematology, Charitéplatz 1, 10117 Berlin, Germany
| | - Georg Seifert
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatrics, Division of Oncology and Hematology, Charitéplatz 1, 10117 Berlin, Germany; University of São Paulo, Faculty of Medicine, Department of Pediatrics, São Paulo, Brazil
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Abstract
This study was conducted to evaluate the effect of yoga on pain levels in female students with primary dysmenorrhea. This study is a randomized experimental study with control group and pretest post-test practice. This study included 60 volunteer female students (30 experimental and 30 control groups). The patients in the experimental group took part in the yoga program a total of 12 sessions, once per week for 12 weeks. "Personal Information Form", "Visual Analog Skala (VAS)" and "Dysmenorrhea Monitoring Form (DMF)" were used in data collection process. To measure dysmenorrhea pain, the students were requested to mark a number between 1 and 10 on the VAS scale according to the severity of their pain on the menstruation starting date. The yoga applications were used for three menstrual cycles. The mean age of the students in the experimental group was 20.30 ± 0.46, while the mean age of the students in the control group was 20.46 ± 0.50. The difference between the pain levels of the students in the experimental group in the first, second, third and fourth measurements was found to be statistically significant (p < 0.001). It was determined that the difference between the pain levels of the students in the control group in the first, second, third and fourth measurements was not statistically significant (p > 0.05). Yoga can be used as an effective intervention in reducing menstrual pain in women with primary dysmenorrhea.
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Affiliation(s)
- Nurcan Kirca
- Faculty of Nursing, Department of Obstetrics & Gynecological Nursing, Akdeniz University, Antalya, Turkey
| | - AslıSis Celik
- Faculty of Nursing, Department of Obstetrics & Gynecological Nursing, Ataturk University, Erzurum, Turkey
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Mohammadi A, Mehraban AH, Damavandi SA, Zarei MA, Haghani H. The effect of play-based occupational therapy on symptoms and participation in daily life activities in children with cancer: A randomized controlled trial. Br J Occup Ther 2021. [DOI: 10.1177/0308022620987125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction This study aimed to investigate the effect of play-based occupational therapy on symptoms and participation in daily life activities in hospitalized children with cancer undergoing chemotherapy. Method A total of 25 children (mean age = 9.28 ± 0.95 years, range = 7–12 years) with cancer undergoing chemotherapy were enrolled and randomly assigned to a play-based occupational therapy group ( n = 12) or control group ( n = 13). The intervention group received eight 1-hour play-based occupational therapy sessions, and the control group received traditional occupational therapy services. Participation in daily life activities, therapy-related symptoms, pain, anxiety, and fatigue were evaluated. Results Total mean scores of participation in daily life activities in the intervention group in the diversity of activities ( p = 0.001, d = 1.39), intensity of participation ( p = 0.001, d = 1.86), with whom done ( p = 0.005, d = 1.22), enjoyment ( p = 0.003, d = 1.33), and parents’ satisfaction ( p = 0.003, d = 1.33) were significantly higher than the control group. Symptoms decreased in both groups; however, this trend had a significant difference in the intervention group for the therapy-related symptom checklist ( p = 0.001, d = 1.68), pain ( p = 0.001, d = 1.61), anxiety ( p = 0.001, d = 1.58), and fatigue ( p = 0.002, d = 1.39) scores. Conclusion A 2-week course of inpatient play-based occupational therapy is an effective approach in the reduction of cancer symptoms, therapy-related symptoms, and the participation facilitation, of children with cancer in daily life activities.
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Affiliation(s)
- Ahmad Mohammadi
- Department of Occupational Therapy, Rehabilitation Faculty, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Afsoon Hassani Mehraban
- Occupational Therapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences, Teran, Islamic Republic of Iran
| | - Shahla Ansari Damavandi
- Pediatric Hematology and Oncology Department, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mehdi Alizadeh Zarei
- Occupational Therapy Department, School of Rehabilitation, Iran University of Medical Sciences (IUMS), Tehran, Islamic Republic of Iran
| | - Hamid Haghani
- Biostatistics Department, School of Management, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
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Amini N, Shiravi A, Mirazi N, Hojati V, Abbasalipourkabir R. Protective effects of the fruit extract of raspberry ( Rubus fruticosus L.) on pituitary-gonadal axis and testicular histopathology in streptozotocin induced diabetic male rats. AVICENNA JOURNAL OF PHYTOMEDICINE 2021; 11:199-209. [PMID: 33907678 PMCID: PMC8051313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 08/05/2020] [Accepted: 08/11/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Protective effects of raspberry (Rubus fruticosus L.) fruit extract on pituitary-gonadal axis and testicular tissue in diabetic male rats, were investigated. MATERIALS AND METHODS Sixty male rats were divided into control, sham (saline treated), streptozotocin (STZ)-diabetic, and STZ-diabetic animals treated with 50, 100 and 200 mg/kg/day of raspberry extract. After 4 weeks, blood samples were obtained and left testes were removed and prepared for histopathological studies. Serum levels of Luteinizing hormone (LH), Follicle stimulating hormone (FSH), testosterone, Nitric oxide (NO), and malondialdehyde (MDA), as well as superoxide dismutase (SOD) and catalase (CAT) activity level were assayed. Sperm number and motility in the epididymis samples were measured. Data were analyzed using ANOVA (one-way analysis of variance). RESULTS Serum levels of LH, FSH and MDA significantly increased in diabetic rats, however, treatment with the extract significantly reversed the alterations. Serum levels of testosterone and NO, activity of SOD and CAT, and sperm number and motility significantly decreased and severe destruction of testicular histology was observed in diabetic animals while treatment with the extract significantly reversed the pathologic alterations observed in diabetic rats. According to the results, 100 and 200 mg/kg of the extract were able to effectively reverse the diabetes complications. CONCLUSION Our findings demonstrated that the fruit extract of raspberry has protective effects on male reproductive system in diabetic rats partially due to its improving effects on NO system, and SOD and CAT activity.
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Affiliation(s)
- Nooshin Amini
- Department of Biology, Damghan Branch, Islamic Azad University, Damghan, Iran
| | | | - Naser Mirazi
- Department of Biology, Faculty of Basic Sciences, Bu- Ali Sina University, Hamedan, Iran
| | - Vida Hojati
- Department of Biology, Damghan Branch, Islamic Azad University, Damghan, Iran
| | - Roghayeh Abbasalipourkabir
- Department of Clinical Biochemistry, School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran
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12
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Ito N, Petrella A, Sabiston C, Fisher A, Pugh G. A Systematic Review and Narrative Synthesis of Exercise Interventions to Manage Fatigue Among Children, Adolescents, and Young Adults with Cancer. J Adolesc Young Adult Oncol 2021; 10:361-378. [PMID: 33625879 DOI: 10.1089/jayao.2020.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Exercise is known to improve fatigue among adult cancer patients however there is limited understanding of this relationship in children, adolescents, and young adults (AYA) with cancer. The aim is to evaluate the effect of exercise on fatigue outcomes among children and AYA with cancer and to identify important parameters of exercise (frequency, intensity, time, type, and setting), which may be relevant for future intervention design. A systematic search of PubMed, MedLine, CENTRAL, Embase, and Web of Science databases was conducted in December 2019, for studies within the last decade, reporting the effect of exercise on fatigue among cancer patients and survivors 0-24 years of age. Quality assessment was conducted using the Physiotherapy Evidence Database (PEDro) and "Before/After Studies with No Control Group" scales. Seventeen studies (n = 681 participants) were included, of which six were randomized controlled trials (RCTs), and the remaining being pilot (n = 5) or feasibility studies (n = 6). Across studies there was great heterogeneity in intervention delivery, frequency (range: 1-7 days a week), time (range: 10-60 minutes), and duration (range: 3-24 weeks). A positive effect of exercise on fatigue was observed, however, most changes in fatigue were not statistically significant. Exercise is beneficial for reducing fatigue in young cancer patients. However, due to the heterogeneity and quality of existing interventions, firm conclusions about the most effective mode and format of exercise intervention cannot be drawn. There is a need for more definitive large-scale RCTs that can provide data of sufficient quality.
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Affiliation(s)
- Nonoka Ito
- Centre for Sports and Exercise Medicine, Queen Mary University of London, London, United Kingdom
| | - Anika Petrella
- Department of Kinesiology, University of Toronto, Toronto, Canada
| | | | - Abigail Fisher
- Department of Behavioral Science and Health, University College London, London, United Kingdom
| | - Gemma Pugh
- Centre for Sports and Exercise Medicine, Queen Mary University of London, London, United Kingdom
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13
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Fukuhara JS, O'Haver J, Proudfoot JA, Spies JM, Kuo DJ. Yoga as a Complementary and Alternative Therapy in Children with Hematologic and Oncologic Disease. J Pediatr Oncol Nurs 2020; 37:278-283. [PMID: 32167404 DOI: 10.1177/1043454220909787] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A diagnosis of a hematologic or oncologic disease in a child can be stressful for the patient and the family. Yoga as an intervention has been reported to decrease stress in adults diagnosed with chronic disorders but few studies have been reported with children and their families. A convenience sample of patients diagnosed with cancer or a blood disorder (ages 7-17 years) and their caregivers was selected to participate in a single bedside yoga class. Participants were surveyed pre and post yoga with the Spielberger State Trait Anxiety Scale. Children were also surveyed pre and post yoga with the Wong-Baker Faces Pain Scale. Children had a significant decrease in pain post yoga but no change in anxiety. Adolescents and parents had a significant decrease in anxiety post yoga intervention.
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Affiliation(s)
- Julia S Fukuhara
- Division of Pediatric Hematology-Oncology, Rady Children's Hospital San Diego/University of California, San Diego, CA, USA
| | - Judith O'Haver
- Division of Pediatric Hematology-Oncology, Rady Children's Hospital San Diego/University of California, San Diego, CA, USA
| | - James A Proudfoot
- Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Jeanie M Spies
- Division of Pediatric Hematology-Oncology, Rady Children's Hospital San Diego/University of California, San Diego, CA, USA
| | - Dennis J Kuo
- Division of Pediatric Hematology-Oncology, Rady Children's Hospital San Diego/University of California, San Diego, CA, USA
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14
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Abuatiq A, Brown R, Wolles B, Randall R. Perceptions of Stress: Patient and Caregiver Experiences With Stressors During Hospitalization. Clin J Oncol Nurs 2020; 24:51-57. [DOI: 10.1188/20.cjon.51-57] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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15
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Mascaro JS, Waller AV, Wright L, Leonard T, Haack C, Waller EK. Individualized, Single Session Yoga Therapy to Reduce Physical and Emotional Symptoms in Hospitalized Hematological Cancer Patients. Integr Cancer Ther 2020; 18:1534735419861692. [PMID: 31311341 PMCID: PMC6637829 DOI: 10.1177/1534735419861692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objective: Inpatient treatment of hematological cancer is among the most physically and mentally arduous cancer treatments, and it is associated with a number of common physical, emotional, and social symptoms that can negatively affect quality of life (QOL) for years following treatment. While treating symptoms during hospitalization holds promise for improving long-term QOL, successful approaches likely require multidisciplinary interventions. In this article, we describe a 4-year effort in program enhancement that incorporated an adjunctive single yoga therapy session during treatment for hematological malignancies. Methods: Hospitalized patients receiving treatment for hematological cancer (N = 486) were provided a 40-minute individualized yoga therapy session. We evaluated feasibility and acceptance by quantifying the percentage of patients who discontinued the yoga session due to pain, discomfort, or another reason, and by comparing the intervention population to the demographic makeup of the unit more generally. Patient-reported symptoms were obtained before and after each session, and we evaluated acute symptom change for the entire sample and in subsamples that are less likely to use mindfulness-based interventions such as yoga. Results: The majority of sessions (87%) were completed, and the majority of unfinished sessions were interrupted by a medical procedure or because the patient fell asleep. No session was stopped early due to patients’ reported pain. Significant decreases were reported in all symptoms, with the greatest decrease in fatigue and anxiety. Conclusions: Yoga therapy was a feasible and effective nondrug adjunct intervention for hospitalized patients receiving treatment for hematological cancer, including bone marrow transplantation.
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16
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Shank J, Chamorro-Viña C, Guilcher GMT, Langelier DM, Schulte F, Culos-Reed SN. Evaluation Tools for Physical Activity Programs for Childhood Cancer: A Scoping Review. J Pediatr Oncol Nurs 2019; 37:163-179. [PMID: 31847707 DOI: 10.1177/1043454219891987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Research on the benefits of physical activity (PA) in childhood cancer has been translated into a handful of community-based programs. However, to foster further translation, an understanding of how to evaluate participant outcomes would be beneficial to provide feedback to participants and stimulate future research. Such a review would provide a summary of acceptable tools for work in this area. The purpose of this scoping review was to identify the evaluation tools that have been used in PA/exercise studies or programs for childhood cancer. This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies included in the review used physical and psychosocial evaluation tools within PA and exercise programs or research for childhood cancer. In addition, studies with measures of health behavior such as PA levels and activities of daily living were included. Tools that assessed physical fitness and physical performance were excluded. Information on the types of evaluation tools used, mean age of participants, and type of cancer was extracted. Psychometric properties of each evaluation tool are reported. The most commonly assessed patient outcomes were motor performance, fatigue, well-being, functional mobility, and quality of life. Less commonly reported patient outcomes were hope, self-efficacy, and self-perception. None of the evaluation tools reported in the PA/exercise and pediatric oncology literature assess physical literacy. This review was the first step in a knowledge translation process, identifying evaluation tools that have been used in PA/exercise programs in childhood cancer survivors, that will guide the development and evaluation of current and future community-based programs.
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Affiliation(s)
- Jena Shank
- University of Calgary, Calgary, Alberta, Canada
| | - Carolina Chamorro-Viña
- University of Calgary, Calgary, Alberta, Canada.,Kids Cancer Care Foundation of Alberta, Calgary, Alberta, Canada
| | - Gregory M T Guilcher
- University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital, Calgary, Alberta, Canada
| | | | | | - S Nicole Culos-Reed
- University of Calgary, Calgary, Alberta, Canada.,Alberta Health Services, Calgary, Alberta, Canada
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17
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Daniel LC, Litsenburg RR, Rogers VE, Zhou ES, Ellis SJ, Wakefield CE, Stremler R, Walter L, Crabtree VM. A call to action for expanded sleep research in pediatric oncology: A position paper on behalf of the International Psycho‐Oncology Society Pediatrics Special Interest Group. Psychooncology 2019; 29:465-474. [PMID: 31654575 PMCID: PMC9539613 DOI: 10.1002/pon.5242] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/14/2019] [Accepted: 09/18/2019] [Indexed: 12/21/2022]
Abstract
Sleep and circadian rhythms are closely related to physical and psychosocial well‐being. However, sleep and circadian rhythm disruptions are often overlooked in children with cancer, as they are frequently considered temporary side effects of therapy that resolve when treatment ends. Yet, evidence from adult oncology suggests a bidirectional relationship wherein cancer and its treatment disrupt sleep and circadian rhythms, which are associated with negative health outcomes such as poor immune functioning and lower survival rates. A growing body of research demonstrates that sleep problems are prevalent among children with cancer and can persist into survivorship. However, medical and psychosocial outcomes of poor sleep and circadian rhythmicity have not been explored in this context. It is essential to increase our understanding because sleep and circadian rhythms are vital components of health and quality of life. In children without cancer, sleep and circadian disturbances respond well to intervention, suggesting that they may also be modifiable in children with cancer. We present this paper as a call to (a) incorporate sleep or circadian rhythm assessment into pediatric cancer clinical trials, (b) address gaps in understanding the bidirectional relationship between sleep or circadian rhythms and health throughout the cancer trajectory, and (c) integrate sleep and circadian science into oncologic treatment.
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Affiliation(s)
- Lauren C. Daniel
- Faculty of Arts and SciencesRutgers University Camden Camden New Jersey
| | - Raphaele R.L. Litsenburg
- Princess Máxima Center for Pediatric Oncology Utrecht and Amsterdam UMCVU University Medical Center Amsterdam Amsterdam Netherlands
| | - Valerie E. Rogers
- Family & Community HealthUniversity of Maryland Baltimore School of Nursing Baltimore Maryland
| | - Eric S. Zhou
- Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Sarah J. Ellis
- School of Women's and Children's HealthUNSW Sydney Kensington New South Wales Australia
- School of PsychologyThe University of Sydney Australia
| | - Claire E. Wakefield
- School of Women's and Children's HealthUNSW Sydney Kensington New South Wales Australia
- Kids Cancer CentreSydney Children's Hospital Randwick New South Wales Australia
| | - Robyn Stremler
- Lawrence S. Bloomberg Faculty of NursingUniversity of Toronto, and The Hospital for Sick Children Toronto Ontario Canada
| | - Lisa Walter
- The Ritchie CentreHudson Institute of Medical Research and the Department of PaediatricsMonash University Melbourne Victoria Australia
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18
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Esbenshade AJ, Ness KK. Dietary and Exercise Interventions for Pediatric Oncology Patients: The Way Forward. J Natl Cancer Inst Monogr 2019; 2019:157-162. [PMID: 31532528 DOI: 10.1093/jncimonographs/lgz021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/30/2019] [Accepted: 07/01/2019] [Indexed: 12/29/2022] Open
Abstract
Abstract
This review focuses on diet and exercise interventions that have been conducted in pediatric cancer and pediatric stem cell transplant patients. It examines the different reasons for conducting lifestyle interventions with attention to the different outcome measurements and feasibility of these measures with an argument toward a need for standardization to move the field forward.
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Affiliation(s)
- Adam J Esbenshade
- Vanderbilt-Ingram Cancer Center, Nashville, TN (AJE)
- Monroe Carell Jr. Children’s Hospital at Vanderbilt Division of Pediatric Hematology-Oncology, Nashville, TN (AJE)
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN (KKN)
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19
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Stein E, Rayar M, Krishnadev U, Gupta A, Hyslop S, Plenert E, Schechter-Finkelstein T, Sung L. A feasibility study examining the impact of yoga on psychosocial health and symptoms in pediatric outpatients receiving chemotherapy. Support Care Cancer 2019; 27:3769-3776. [DOI: 10.1007/s00520-019-04673-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 01/21/2019] [Indexed: 11/24/2022]
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20
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Severely bothersome fatigue in children and adolescents with cancer and hematopoietic stem cell transplant recipients. Support Care Cancer 2018; 27:2665-2671. [PMID: 30478671 DOI: 10.1007/s00520-018-4555-9] [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] [Received: 05/02/2018] [Accepted: 11/13/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Objectives were to describe bothersome fatigue in children with cancer and hematopoietic stem cell (HSCT) recipients and to identify factors associated with severely bothersome fatigue. METHODS We included children ages 8-18 years treated for cancer or HSCT recipients from three groups: [1] receiving active cancer treatment and admitted to hospital for at least 3 days, [2] attending outpatient clinic for acute lymphoblastic leukemia maintenance therapy, and [3] attending outpatient clinic following treatment completion. Fatigue was measured using the Symptom Screening in Pediatrics Tool (SSPedi); severely bothersome fatigue was defined as a lot or extremely bothersome fatigue (score of 3-4 on 0-4 scale). Factors associated with severely bothersome fatigue were examined using univariate and multiple logistic regression. RESULTS Of 502 children included, 414 (82.5%) reported some degree of bothersome fatigue (scores 1-4), and 123 (24.5%) reported severely bothersome fatigue (score 3 or 4). In multiple regression analysis, factors significantly associated with severely bothersome fatigue were child age 11-14 and 15-18 years vs 8-10 years (odds ratio (OR) 2.11, 95% confidence interval (CI) 1.21-3.77 and OR 2.96, 95% CI 1.66-5.44), and inpatients receiving cancer treatment vs outpatients who had completed therapy (OR 3.85, 95% CI 2.17-7.27). CONCLUSIONS We found that 82.5% of children with cancer or HSCT recipients reported bothersome fatigue and 24.5% of children reported severely bothersome fatigue. Risk factors for severely bothersome fatigue were older age and inpatients receiving active cancer treatment. Future work should evaluate systematic symptom screening in clinical practice and apply interventions to reduce fatigue.
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21
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Nunes MDR, Bomfim E, Olson K, Lopes-Junior LC, Silva-Rodrigues FM, Garcia de Lima RA, Nascimento LC. Interventions minimizing fatigue in children/adolescents with cancer: An integrative review. J Child Health Care 2018; 22:186-204. [PMID: 29361838 DOI: 10.1177/1367493517752498] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Fatigue is among the most common, debilitating, and distressing symptoms associated with chronic condition in pediatric population. The purpose of this study was to identify non-pharmacological fatigue interventions in children and adolescents with cancer. For this, we carried out an integrative review of the literature from January 2000 to December 2016. A comprehensive search of four databases was conducted: Cumulative Index to Nursing and Allied Health Literature, Psychology Information, Medline via PubMed, and Web of Science. Randomized controlled trial, quasi-experimental, case-control and cohort studies were included in this review. Thirteen relevant studies were included for analysis. Seven papers reported positive outcomes for exercise, exercise plus leisure activities, healing touch and acupressure. In another six papers using exercise, exercise plus psychological intervention and massage, no effectiveness was found. Effective management of fatigue in children and adolescents is important but research in this area is limited, so the results of this review should be interpreted cautiously. Future researchers are encouraged to test the effective interventions in homogenous cancer populations and in other groups where fatigue is a common concern.
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Affiliation(s)
| | - Emiliana Bomfim
- 2 College of Medicine Department of Health Sciences, University of Saskatchewan, Saskatoon, Canada
| | - Karin Olson
- 3 Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Luis Carlos Lopes-Junior
- 4 Department of Maternal-Infant and Public Health Nursing at Ribeirão Preto College of Nursing, University of São Paulo, Brazil
| | | | - Regina Aparecida Garcia de Lima
- 4 Department of Maternal-Infant and Public Health Nursing at Ribeirão Preto College of Nursing, University of São Paulo, Brazil
| | - Lucila Castanheira Nascimento
- 4 Department of Maternal-Infant and Public Health Nursing at Ribeirão Preto College of Nursing, University of São Paulo, Brazil
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22
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Management of fatigue in children and adolescents with cancer and in paediatric recipients of haemopoietic stem-cell transplants: a clinical practice guideline. THE LANCET CHILD & ADOLESCENT HEALTH 2018; 2:371-378. [PMID: 30169270 DOI: 10.1016/s2352-4642(18)30059-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 02/02/2018] [Accepted: 02/08/2018] [Indexed: 12/29/2022]
Abstract
Fatigue is a prevalent and distressing symptom in children and adolescents with cancer and in those who have undergone haemopoietic stem-cell transplantation. A multidisciplinary and multinational group of experts in paediatric oncology and fatigue, together with patient advocates, developed a clinical practice guideline for management of fatigue on the basis of systematic reviews that included six paediatric and 456 adult randomised studies. We used the Grading of Recommendations Assessment, Development and Evaluation approach to generate recommendations, and made strong recommendations, supported by evidence of moderate quality, for use of physical activity, relaxation, and mindfulness to reduce fatigue. When these approaches are unsuccessful or not feasible, cognitive or cognitive behavioural therapies may be offered (weak recommendation supported by evidence of moderate quality). Maturity and cognitive ability of individual patients will affect the feasibility of interventions. Systemic pharmacological approaches should not be routinely used to manage fatigue in children. Apart from identification of optimal approaches to implement recommended interventions in clinical practice, future research should also address knowledge gaps, including establishment of minimum age thresholds for interventions and inclusion of paediatric patients in randomised trials of fatigue management.
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23
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Jafari H, Janati Y, Yazdani J, Bali N, Hassanpour S. The Effect of Relaxation Technique on Fatigue Levels after Stem Cell Transplant. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:388-394. [PMID: 30186345 PMCID: PMC6111655 DOI: 10.4103/ijnmr.ijnmr_26_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background: Many patients undergoing hematopoietic stem cell transplant (HSCT) experience fatigue due to their disease process and its long period of treatment. Using nonpharmacological methods to help reduce their fatigue is a reasonable endeavor. The present study was conducted to investigate the effect of Benson's relaxation technique on fatigue levels in patients after HSCT. Materials and Methods: Thirty-seven patients were randomly selected to the intervention (n = 19) and control group (n = 18). In the intervention group, the participants performed Benson's relaxation exercises for 20 min twice per day over a period of 15 days. The data collection tools used included a demographic and medical information form and the Brief Fatigue Inventory, completed by both groups on three different occasions (upon admission and days 8 and 14 after the HSCT). The data obtained were analyzed in Statistical Package for the Social Sciences version-20 using statistical tests. Results: The results of the independent t-test showed no significant preintervention differences in fatigue levels between the two groups. On days 8 (t = 11.21, p < 0.001) and 14 after the transplant (t = 15.62, p < 0.001), a significant difference was observed in the mean level of fatigue between the two groups. Conclusions: These findings indicate that Benson's relaxation technique would improve fatigue in HSCT patients.
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Affiliation(s)
- Hedayat Jafari
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Traditional and Complementary Medicine Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Yadollah Janati
- Department of Psychiatry and Behavior, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nasrin Bali
- Department of Psychiatry and Behavior, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Somayeh Hassanpour
- Department of Critical Care Nursing, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
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Abstract
To cope with cancer and its treatment-related side effects and toxicities, people are increasingly using complementary and alternative medicine (CAM). Consequently, integrative oncology, which combines conventional therapies and evidence-based CAM practices, is an emerging discipline in cancer care. The use of yoga as a CAM is proving to be beneficial and increasingly gaining popularity. An electronic database search (PubMed), through December 15, 2016, revealed 138 relevant clinical trials (single-armed, nonrandomized, and randomized controlled trials) on the use of yoga in cancer patients. A total of 10,660 cancer patients from 20 countries were recruited in these studies. Regardless of some methodological deficiencies, most of the studies reported that yoga improved the physical and psychological symptoms, quality of life, and markers of immunity of the patients, providing a strong support for yoga's integration into conventional cancer care. This review article presents the published clinical research on the prevalence of yoga's use in cancer patients so that oncologists, researchers, and the patients are aware of the evidence supporting the use of this relatively safe modality in cancer care.
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Affiliation(s)
- Ram P Agarwal
- Department of Medicine, Division of Oncology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Adi Maroko-Afek
- Department of Medicine, Division of Oncology, Miller School of Medicine, University of Miami, Miami, Florida, USA
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25
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Rustler V, Hagerty M, Daeggelmann J, Marjerrison S, Bloch W, Baumann FT. Exercise interventions for patients with pediatric cancer during inpatient acute care: A systematic review of literature. Pediatr Blood Cancer 2017; 64. [PMID: 28423225 DOI: 10.1002/pbc.26567] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 02/25/2017] [Accepted: 03/03/2017] [Indexed: 02/05/2023]
Abstract
Physical inactivity has been shown to exacerbate negative side effects experienced by pediatric patients undergoing cancer therapy. Exercise interventions are being created in response. This review summarizes current exercise intervention data in the inpatient pediatric oncology setting. Two independent reviewers collected literature from three databases, and analyzed data following the PRISMA statement for systematic reviews and meta-analyses. Ten studies were included, representing 204 patients. Good adherence, positive trends in health status, and no adverse events were noted. Common strategies included individual, supervised, combination training with adaptability to meet fluctuating patient abilities. We recommend that general physical activity programming be offered to pediatric oncology inpatients.
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Affiliation(s)
- Vanessa Rustler
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany
| | - Meaghan Hagerty
- Faculty of Health Sciences, Global Health, McMaster University, Hamilton, Canada
| | - Julia Daeggelmann
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany
| | - Stacey Marjerrison
- Department of Hematology and Oncology, McMaster Children's Hospital, McMaster University, Hamilton, Canada
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany
| | - Freerk T Baumann
- Department 1 of Internal Medicine, Center for Integrated Oncology Cologne/Bonn, University Hospital Cologne, Germany
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Jibb LA, Stevens BJ, Nathan PC, Seto E, Cafazzo JA, Johnston DL, Hum V, Stinson JN. Implementation and preliminary effectiveness of a real-time pain management smartphone app for adolescents with cancer: A multicenter pilot clinical study. Pediatr Blood Cancer 2017; 64. [PMID: 28423223 DOI: 10.1002/pbc.26554] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 02/15/2017] [Accepted: 02/20/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pain in adolescents with cancer (12-18 years) is common and negatively impacts health-related quality of life (HRQL). The Pain Squad+ smartphone app, which provides adolescents with real-time pain self-management support, was developed to address this issue. This study evaluated the implementation of the app to inform a future randomized controlled trial (RCT) and obtain treatment effect estimates for pain intensity, pain interference, HRQL, and self-efficacy. PROCEDURE A one-group baseline/poststudy design with 40 adolescents recruited from two pediatric tertiary care centers was used. Baseline questionnaires were completed and adolescents used the app at least twice daily for 28 days, receiving algorithm-informed self-management advice depending on their reported pain. A nurse received alerts in response to sustained pain and contacted adolescents to assist in pain care. Poststudy questionnaires were completed. Descriptive analyses, with exploratory inferential testing conducted on health outcome data, were used to address study aims. RESULTS Most (40/52; 77%) eligible adolescents participated. Two participants withdrew participation. Intervention fidelity was impacted by technical difficulties (occurring for 15% of participants) and a prolonged time for nurse contact in the event of sustained pain. Adherence to pain reporting was 68.8 ± 38.1%. Outcome measure completion rates were high and the intervention was acceptable to participants. Trends in improvements in pain intensity, pain interference, and HRQL were significant, with effect sizes of 0.23-0.67. CONCLUSIONS Implementation of Pain Squad+ is feasible and the app appears to improve pain-related outcomes for adolescents with cancer. A multicenter RCT will be undertaken to examine app effectiveness.
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Affiliation(s)
| | - Bonnie J Stevens
- Hospital for Sick Children, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Paul C Nathan
- Hospital for Sick Children, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Emily Seto
- University of Toronto, Toronto, Canada.,University Health Network, Toronto, Canada
| | - Joseph A Cafazzo
- University of Toronto, Toronto, Canada.,University Health Network, Toronto, Canada
| | - Donna L Johnston
- University of Ottawa, Ottawa, Canada.,Children's Hospital of Eastern Ontario, Ottawa, Canada
| | | | - Jennifer N Stinson
- Hospital for Sick Children, Toronto, Canada.,University of Toronto, Toronto, Canada
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Jafari H, Jannati Y, Nesheli HM, Hassanpour S. Effects of nonpharmacological interventions on reducing fatigue after hematopoietic stem cell transplantation. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:13. [PMID: 28458705 PMCID: PMC5367206 DOI: 10.4103/1735-1995.199094] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 10/02/2016] [Accepted: 10/31/2016] [Indexed: 01/22/2023]
Abstract
Fatigue is one of the main complaints of patients undergoing allogeneic and autologous hematopoietic stem cell transplantation (HSCT). Since nonpharmacological interventions are cost-effective and causes fewer complications, this study aimed to review the studies performed on the effects of nonpharmacological interventions on fatigue in patients undergoing HSCT during September 2016. MEDLINE, CINAHL, Scientific Information Database, IranMedex, PubMed, ScienceDirect, Scopus, Magiran, and IRANDOC databases were searched using Persian and English keywords. A total of 1217 articles were retrieved, 21 of which were used in this study. Exercise is known as an effective intervention in alleviating physical and mental problems of patients undergoing stem cell transplant. This review-based study showed that nonpharmacological methods such as exercise might be effective in decreasing fatigue in patients undergoing stem cell transplant. There is a multitude of studies on some of the complementary and alternative therapy methods, such as music therapy, yoga, relaxation, and therapeutic massage. These studies demonstrated the positive effects of the aforementioned therapies on reduction of fatigue in patients undergoing stem cell transplantation. All the investigated methods in this study were nonaggressive, safe, and cost-effective and could be used along with common treatments or even as an alternative for pharmacological treatments for the reduction, or elimination of fatigue in patients undergoing stem cell transplantation. Given the advantages of complementary and alternative medicine, conducting further studies on this issue is recommended to reduce fatigue in patients after stem cell transplantation.
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Affiliation(s)
- Hedayat Jafari
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Traditional and Complementary Medicine Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Yadollah Jannati
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hassan Mahmoodi Nesheli
- Noncommunicable Pediatric Diseases Research Center, Amirkola Children's Hospital, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Somayeh Hassanpour
- Department of Critical Care Nursing, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
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Review of yoga therapy during cancer treatment. Support Care Cancer 2017; 25:1357-1372. [PMID: 28064385 DOI: 10.1007/s00520-016-3556-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 12/27/2016] [Indexed: 12/18/2022]
Abstract
PURPOSE Reviews of yoga research that distinguish results of trials conducted during (versus after) cancer treatment are needed to guide future research and clinical practice. We therefore conducted a review of non-randomized studies and randomized controlled trials of yoga interventions for children and adults undergoing treatment for any cancer type. METHODS Studies were identified via research databases and reference lists. Inclusion criteria were the following: (1) children or adults undergoing cancer treatment, (2) intervention stated as yoga or component of yoga, and (3) publication in English in peer-reviewed journals through October 2015. Exclusion criteria were the following: (1) samples receiving hormone therapy only, (2) interventions involving meditation only, and (3) yoga delivered within broader cancer recovery or mindfulness-based stress reduction programs. RESULTS Results of non-randomized (adult n = 8, pediatric n = 4) and randomized controlled trials (adult n = 13, pediatric n = 0) conducted during cancer treatment are summarized separately by age group. Findings most consistently support improvement in psychological outcomes (e.g., depression, distress, anxiety). Several studies also found that yoga enhanced quality of life, though further investigation is needed to clarify domain-specific efficacy (e.g., physical, social, cancer-specific). Regarding physical and biomedical outcomes, evidence increasingly suggests that yoga ameliorates sleep and fatigue; additional research is needed to advance preliminary findings for other treatment sequelae and stress/immunity biomarkers. CONCLUSIONS Among adults undergoing cancer treatment, evidence supports recommending yoga for improving psychological outcomes, with potential for also improving physical symptoms. Evidence is insufficient to evaluate the efficacy of yoga in pediatric oncology. We describe suggestions for strengthening yoga research methodology to inform clinical practice guidelines.
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Results of a Pilot Yoga Intervention to Improve Pediatric Cancer Patients' Quality of Life and Physical Activity and Parents' Well-being. REHABILITATION ONCOLOGY 2017. [DOI: 10.1097/01.reo.0000000000000052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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McNamara C, Johnson M, Read L, Vander Velden H, Thygeson M, Liu M, Gandrud L, McNamara J. Yoga Therapy in Children with Cystic Fibrosis Decreases Immediate Anxiety and Joint Pain. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:9429504. [PMID: 28077950 PMCID: PMC5204083 DOI: 10.1155/2016/9429504] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 10/12/2016] [Accepted: 11/21/2016] [Indexed: 12/17/2022]
Abstract
This study was designed to determine whether yoga might alleviate symptoms of pain, sleep disturbance, anxiety, and depression in children with cystic fibrosis (CF). CF is the most common genetic, life-limiting chronic disease among Caucasian populations. It primarily affects the lungs but also many other secretory organs and consequently leads to significant morbidities. Research has shown that children with CF have significantly increased depression, anxiety, and pain compared to their healthy counterparts. Subjects participated in six one-on-one sessions over a 10-week period with a certified instructor who designed each yoga practice based on a preestablished list of 30 yoga asanas. Questionnaires evaluating pain, sleep disturbance, sustained anxiety, immediate anxiety, and depression were administered. Differences between premeasures and postmeasures were evaluated using a two-sided test. Twenty subjects were assessed (12 females/8 males), median age of 11 (7-20) years. Mean immediate anxiety scores decreased (before session to after session 29 to 23.6, respectively, p < 0.001). Joint pain improved (3.25 to 3.65, p = 0.028). CFQ-R emotion subscale improved from 79.2 to 85 (p = 0.073), and the respiratory subscale improved from 66.7 to 79.2 (p = 0.076). Other results were less notable. We conclude that yoga may reduce immediate anxiety and joint pain in patients with CF.
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Affiliation(s)
| | - Mahrya Johnson
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - Lisa Read
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | | | - Megan Thygeson
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - Meixia Liu
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - Laura Gandrud
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - John McNamara
- Children's Respiratory and Critical Care Specialists, PA, Minneapolis, MN, USA
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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Grimshaw SL, Taylor NF, Shields N. The Feasibility of Physical Activity Interventions During the Intense Treatment Phase for Children and Adolescents with Cancer: A Systematic Review. Pediatr Blood Cancer 2016; 63:1586-93. [PMID: 27186955 DOI: 10.1002/pbc.26010] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/11/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND Physical activity may have benefits for children undergoing intense treatment for cancer, but such programmes are challenging to implement. This systematic review aimed to investigate the feasibly of physical activity interventions during intense cancer treatment for children and adolescents. PROCEDURE A systematic search of seven electronic databases (Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, Public/Publisher MEDLINE, Psychological Information Database, Sportsdiscuss, Excerpta Medica Database, Allied and Complementary Medicine Database) from 2005 to August 2015 was completed. The risk of bias was assessed using the Downs and Black Checklist and The Critical Review Form-Qualitative Studies. Results were summarised descriptively across eight domains of feasibility: acceptability, demand, implementation, adaptation, practicality, integration, expansion and limited efficiency testing (including effectiveness). RESULTS Eleven quantitative studies and one qualitative study were identified for inclusion. Physical activity interventions were typically supervised, individualised programmes that prescribed a variety of activity types for hospital inpatients. There was evidence that physical activity interventions during the intense phase of cancer treatment were acceptable to parents and children, safe and successfully implemented. A trend of positive effects across all aspects of functioning was noted. Data were unavailable documenting feasibility for the domains of integration, adaptation and expansion. CONCLUSION There is preliminary evidence that physical activity interventions are feasible, in that they are acceptable, safe and potentially beneficial for children with cancer but more work needs to be done to understand the most effective ways to implement these types of programmes.
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Affiliation(s)
- Sarah L Grimshaw
- School of Allied Health, La Trobe University, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia
| | - Nicholas F Taylor
- School of Allied Health, La Trobe University, Melbourne, Australia.,Allied Health Research Office, Eastern Health, Melbourne, Australia
| | - Nora Shields
- School of Allied Health, La Trobe University, Melbourne, Australia.,Department of Allied Health, Northern Health, Melbourne, Australia
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Diorio C, Celis Ekstrand A, Hesser T, O'Sullivan C, Lee M, Schechter T, Sung L. Development of an Individualized Yoga Intervention to Address Fatigue in Hospitalized Children Undergoing Intensive Chemotherapy. Integr Cancer Ther 2016; 15:279-84. [PMID: 27146130 PMCID: PMC5739190 DOI: 10.1177/1534735416630806] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 01/11/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose. Fatigue is an important problem in children receiving intensive chemotherapy and hematopoietic stem cell transplantation (HSCT). Exercise may be an effective intervention for fatigue. Individualized yoga represents an ideal intervention because it can be tailored according to an individual child’s needs. Little is known about how to structure a standardized yoga program for intensivelytreated children. Therefore, this study describes the development of a yoga program and an approach to monitoring sessions suitable for hospitalized children receiving intensive chemotherapy or HSCT. Methods. The yoga program was designed to increase mobility in hospitalized children and to provide children with relaxation techniques that could be used independently in a variety of environments. The program was founded on 4 key tenets: safety, adaptability, environmental flexibility, and appeal to children. We also developed quality and consistency assurance procedures. Results. A menu format with a fixed structure was selected for the yoga program. Each yoga session contained up to 6 sections: breathing exercises, warmup exercises, yoga poses, balancing poses, cool-down poses, and final relaxation. Yoga instructors selected specific yoga poses for each session from a predetermined list organized by intensity level (low, moderate, or high). Monitoring procedures were developed using videotaping and multirater adjudication. Conclusion. We created a standardized yoga program and an approach to monitoring that are now ready for incorporation in clinical trials. Future work should include the adaptation of the program to different pediatric populations and clinical settings.
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Affiliation(s)
| | | | - Tanya Hesser
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Michelle Lee
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tal Schechter
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lillian Sung
- The Hospital for Sick Children, Toronto, Ontario, Canada
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Steur LMH, Kolk RHE, Mooij F, de Vries R, Grootenhuis MA, Kaspers GJL, Van Litsenburg RRL. The prevalence and risk factors of sleep problems in pediatric oncology: its effect on quality of life during and after cancer treatment. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/23809000.2016.1168265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Lindsay M. H. Steur
- Department of pediatric oncology-hematology, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Roos H. E. Kolk
- Department of pediatric oncology-hematology, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Floor Mooij
- Department of pediatric oncology-hematology, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit, Amsterdam, The Netherlands
| | - Martha A. Grootenhuis
- Psychosocial department, Emma Childrens’ Hospital, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
- Psycho-oncology Research Group, Princess Máxima Center for pediatric oncology Utrecht, Utrecht, The Netherlands
| | - Gertjan J. L. Kaspers
- Department of pediatric oncology-hematology, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
- Director of Academy, Princess Máxima Center for pediatric oncology Utrecht, Utrecht, The Netherlands
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