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Nissen ER, Neumann H, Knutzen SM, Henriksen EN, Amidi A, Johansen C, von Heymann A, Christiansen P, Zachariae R. Interventions for insomnia in cancer patients and survivors-a comprehensive systematic review and meta-analysis. JNCI Cancer Spectr 2024; 8:pkae041. [PMID: 38781520 PMCID: PMC11188797 DOI: 10.1093/jncics/pkae041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/19/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Considering the persistent nature and higher prevalence of insomnia in cancer patients and survivors compared with the general population, there is a need for effective management strategies. This systematic review and meta-analysis aimed to comprehensively evaluate the available evidence for the efficacy of pharmacological and nonpharmacological interventions for insomnia in adult cancer patients and survivors. METHODS Following the PRISMA guidelines, we analyzed data from 61 randomized controlled trials involving 6528 participants. Interventions included pharmacological, physical, and psychological treatments, with a focus on insomnia severity and secondary sleep and non-sleep outcomes. Frequentist and Bayesian analytical strategies were employed for data synthesis and interpretation. RESULTS Cognitive-Behavioral Therapy for Insomnia (CBT-I) emerged as the most efficacious intervention for reducing insomnia severity in cancer survivors and further demonstrated significant improvements in fatigue, depressive symptoms, and anxiety. CBT-I showed a large postintervention effect (g = 0.86; 95% confidence interval [CI] = 0.57 to 1.15) and a medium effect at follow-up (g = 0.55; 95% CI = 0.18 to 0.92). Other interventions such as bright white light therapy, sleep medication, melatonin, exercise, mind-body therapies, and mindfulness-based therapies showed benefits, but the evidence for their efficacy was less convincing compared with CBT-I. Brief Behavioral Therapy for Insomnia showed promise as a less burdensome alternative for patients in active cancer treatment. CONCLUSIONS CBT-I is supported as a first-line treatment for insomnia in cancer survivors, with significant benefits observed across sleep and non-sleep outcomes. The findings also highlight the potential of less intensive alternatives. The research contributes valuable insights for clinical practice and underscores the need for further exploration into the complexities of sleep disturbances in cancer patients and survivors.
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Affiliation(s)
- Eva Rames Nissen
- Unit for Psychooncology and Health Psychology, Department of Oncology Aarhus University Hospital, and Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Henrike Neumann
- Unit for Psychooncology and Health Psychology, Department of Oncology Aarhus University Hospital, and Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Sofie Møgelberg Knutzen
- Unit for Psychooncology and Health Psychology, Department of Oncology Aarhus University Hospital, and Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Emilie Nørholm Henriksen
- Centre for Involvement of Relatives, Mental Health Services, Region of Southern Denmark, Odense, Denmark
| | - Ali Amidi
- Unit for Psychooncology and Health Psychology, Department of Oncology Aarhus University Hospital, and Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Christoffer Johansen
- Cancer Survivorship and Treatment Late Effects (CASTLE) – a Danish Cancer Society National Research Center, Department of Oncology, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Annika von Heymann
- Cancer Survivorship and Treatment Late Effects (CASTLE) – a Danish Cancer Society National Research Center, Department of Oncology, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Peer Christiansen
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark
- Danish Breast Cancer Group Center and Clinic for Late Effects (DCCL), Aarhus University Hospital, Aarhus, Denmark
| | - Robert Zachariae
- Unit for Psychooncology and Health Psychology, Department of Oncology Aarhus University Hospital, and Department of Psychology, Aarhus University, Aarhus, Denmark
- Danish Breast Cancer Group Center and Clinic for Late Effects (DCCL), Aarhus University Hospital, Aarhus, Denmark
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Shallwani SM, Thomas R, King J, Toupin-April K, Poitras S. Perspectives and experiences of leisure-time physical activity in adults with stage 4 cancer: a qualitative interpretive-description study. Disabil Rehabil 2024; 46:1515-1526. [PMID: 37067063 DOI: 10.1080/09638288.2023.2200037] [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: 06/06/2022] [Accepted: 04/03/2023] [Indexed: 04/18/2023]
Abstract
PURPOSE Leisure-time physical activity (LTPA) can be beneficial for individuals with advanced cancer, but little is known on how to tailor rehabilitation strategies targeting LTPA in cancer care. Our objective was to explore perspectives and experiences of LTPA in people with stage 4 cancer. MATERIALS AND METHODS Guided by interpretive-description methodology, our qualitative study consisted of individual, semi-structured interviews with 20 Canadian adults diagnosed with stage 4 cancer. Interviews were transcribed verbatim and analyzed inductively. RESULTS The participants' median age was 51.5 (range, 35-73) years. Cancer types included breast (n = 12), lung (n = 4), and other (n = 4). Participants highlighted their experiences of LTPA as diverse and complex, impacted by individual and cancer-related factors. They emphasized being intentional with LTPA through activity planning and modification. LTPA participation was linked to physical well-being, social connections, and meanings of accomplishment and loss. Many participants desired personalized support related to LTPA, that is integrated, interprofessional, and accessible in cancer care. CONCLUSION The experiences of LTPA for people with stage 4 cancer are personal and connected to health and psychosocial meanings. Further efforts in rehabilitation are needed to address the challenges faced by people with advanced cancer and optimize safe, meaningful participation in LTPA.IMPLICATIONS FOR REHABILITATIONExperiences of leisure-time physical activity in individuals with stage 4 cancer are personal and linked to health benefits and psychosocial meanings.Activity participation frequently involves consideration of cancer-related symptoms, management of risks, and intentional planning and modification of activities.Trained rehabilitation professionals integrated in cancer care may be well suited to support people with stage 4 cancer through personalized activity recommendations.This research can help inform future clinical, research, and educational efforts in rehabilitation aimed at targeting physical activity in individuals with advanced cancer.
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Affiliation(s)
- Shirin M Shallwani
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Lymphedema Research Program, McGill University Health Centre, Montreal, Canada
| | - Roanne Thomas
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Judy King
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Karine Toupin-April
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
- Institut du savoir Montfort, Ottawa, Canada
| | - Stéphane Poitras
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
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Niu N, Huang R, Zhao J, Zeng Y. Health benefits of yoga for cancer survivors: An updated systematic review and meta-analysis. Asia Pac J Oncol Nurs 2024; 11:100316. [PMID: 38426042 PMCID: PMC10904170 DOI: 10.1016/j.apjon.2023.100316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/08/2023] [Indexed: 03/02/2024] Open
Abstract
Objective To evaluate the effects of yoga on health-related outcomes [i.e., physical function, mental health, and overall quality of life (QOL)] of cancer survivors via a systematic review and meta-analysis of randomized controlled trials (RCTs) over the past 5 years across cancer types. Methods An updated systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RCTs published from January 1, 2018, to February 23, 2023, were searched in five English databases (PubMed, The Cochrane Library, ISI, PsycINFO, and CINAHL), three Chinese databases (Wan Fang, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database), and three English clinical trials registry platforms (International Clinical Trials Registry Platform, ClinicalTrials.gov, and EU Clinical Trials Register). Results A total of 34 RCTs were included in this updated review. Yoga benefited the physical function, mental health, and overall QOL of cancer survivors. The effect size of yoga for most physical and mental health-related outcomes was relatively small, but that for the QOL was generally large. The impact of yoga on the QOL of cancer survivors ranged from moderate to high. Conclusions Yoga has health benefits for cancer survivors and could therefore be used as an optional supportive intervention for cancer-related symptom management.
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Affiliation(s)
- Niu Niu
- Department of Colorectal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Ruirui Huang
- School of Nursing, Hunan University of Medicine, Huaihua, China
| | - Junwen Zhao
- Neonatal Intensive Care Unit, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yingchun Zeng
- School of Medicine, Hangzhou City University, Hangzhou, China
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Kaje KC, Dsilva F, Sanal TS, Latha T, Kumar S, D’Souza C. Effect of Yoga Intervention on Inflammatory Biomarkers among Women with Breast Cancer - A Systematic Review. Indian J Palliat Care 2023; 29:223-233. [PMID: 37700899 PMCID: PMC10493689 DOI: 10.25259/ijpc_125_2022] [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: 06/07/2022] [Accepted: 11/18/2022] [Indexed: 01/14/2023] Open
Abstract
Background Inflammatory markers play a substantial role in the prognosis of breast cancer (BC). Studies have been conducted, evaluating the effect of yoga intervention (YI) on inflammatory biomarkers among BC cases. This systematic review consolidates the outcome of YI in the cancer microenvironment. Objective The objective of the study was to evaluate the effect of YI in the cancer microenvironment among BC women. Materials and Methods This review was conducted from May 2021 to December 2021. The inclusion criteria were experimental studies on adult BC cases with isolated YI. Studies conducted among paediatrics, case reports and case series were excluded from the study. Medline (PubMed), Medline (Ovid), Web of Science (WOS), Scopus, CINAHL and Cochrane Central databases were searched. The data were restricted from January 2000 to December 2021 with studies published in English. 'The Cochrane risk of bias assessment tool' was mobilised to evaluate the quality of the included studies. Results A total of nine studies met the inclusion criteria and comprised a sample size of 905 BC cases with a mean age of 50.26±8.27 years. Three studies evaluated tumour necrosis factor-alpha (TNF-α) and INTERLEUKIN (IL)-6, where two studies on TNF-α and one on IL-6 favoured the YI group. A study investigated soluble TNF receptor II (TNF-RII) and another on IL-1beta (IL-1β) has shown improved levels post-YI. A downward trend of cortisol levels was noted in four out of five studies. Two studies that examined the C-reactive protein and a study on IL-8 did not show any difference between the YI and the control groups. Conclusion This review's findings showed the downregulation of cortisol, markers of inflammation; TNF-α, IL-6, TNF-RII and IL-1β immediately to post-YI. Heterogeneities in terms of YIs, number of days of practice, duration and training received and the grade of BC cases are the concern of this review. However, YI can be considered a supportive therapy for BC.
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Affiliation(s)
- Kaini Cecilia Kaje
- Department of Medical Surgical Nursing, Nitte Usha Institute of Nursing Sciences, NITTE (Deemed to be) University, Mangaluru, Karnataka, India
| | - Fatima Dsilva
- Department of Medical Surgical Nursing, Nitte Usha Institute of Nursing Sciences, NITTE (Deemed to be) University, Mangaluru, Karnataka, India
| | - T. S. Sanal
- Department of Research and Statistics, JDC Hospital and Research Center, Trivandrum, Kerala, India
| | - T. Latha
- Department of Medical Surgical Nursing, College of Nursing, AIIMS, Kalyani, West Bengal, India
| | - Shishir Kumar
- Department of Psychiatry, K.S. Hegde Medical Academy, Nitte (Deemed to be) University, Mangaluru, Karnataka, India
| | - Caren D’Souza
- Department of Surgery, K.S. Hegde Medical Academy, Nitte (Deemed to be) University, Mangaluru, Karnataka, India
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Zhu J, Chen X, Zhen X, Zheng H, Chen H, Chen H, Liao H, Zhu J, Wang C, Zheng Z, Chen R, Wang Y. Meta-analysis of effects of yoga exercise intervention on sleep quality in breast cancer patients. Front Oncol 2023; 13:1146433. [PMID: 37456259 PMCID: PMC10348890 DOI: 10.3389/fonc.2023.1146433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/23/2023] [Indexed: 07/18/2023] Open
Abstract
Objective This study seeks to systematically evaluate and test the effects of yoga exercise intervention programs on sleep quality in breast cancer patients in order to suggest more optimized exercise programs. Method Computer searches of the PubMed, Embase, Cochrane Library, Web of Science and CINAHL databases are conducted from the date of their inception to June 8th, 2022 to collect randomized controlled trials on the effects of yoga exercise intervention on sleep quality in breast cancer patients. Two investigators independently carry out the inclusion and exclusion criteria literature screening, data extraction and methodological quality assessment of the included literature by applying the Cochrane risk of bias tool. Subgroup analysis is performed using RevMan 5.4.1 software, and the six moderating variables of intervention format, intervention type, weekly intervention frequency, total intervention duration, single intervention duration and intervention evaluation at different time points are set for the 782 subjects of the 12 included publications. Results Twelve randomized controlled trials with a total sample size of 782 subjects are included, including 393 subjects in the experimental group and 389 subjects in the control group. The meta-analysis shows that yoga exercise intervention is effective in improving sleep quality in breast cancer patients [SMD = -0.40, 95% CI: (-0.71, -0.09), P = 0.01]; yoga exercise intervention focusing on positive meditation [SMD = -0.55, 95% CI: (-1.08, -0.03), P = 0.04] is effective in improving sleep; yoga exercise intervention two or three times a week is effective in improving sleep quality [SMD = -0.69, 95% CI: (-1.19, -0.19), P = 0.007]; yoga exercise intervention for 6-8 weeks significantly improves sleep quality [SMD = -0.86, 95% CI: (-1.65, -0.08), P =0.03]; and evaluation immediately after the end of intervention improves sleep outcomes [SMD = -0.17, 95% CI: (-0.33, 0.00), P = 0.05], while differences in sleep quality improvement are not statistically significant for the remaining subgroup outcomes (P > 0.05). Conclusion The available evidence suggests that yoga exercise intervention has good effects on improving sleep quality in breast cancer patients. Positive meditation intervention type, intervention frequency of two or three times per week, total intervention duration of 6-8 weeks and evaluation immediately after the end of intervention are shown to be effective in improving sleep quality.
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Affiliation(s)
- Jingzhi Zhu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiaojuan Chen
- Medical College, Jiaying University, Meizhou, Guangdong, China
| | - Xinxian Zhen
- Department of Respiratory and Critical Care Medicine, Taishan People's Hospital, Jiangmen, Guangdong, China
| | - Huan Zheng
- Department of Endocrinology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Hong Chen
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Yubei, District of Chongqing City, Chongqing, China
| | - Huimin Chen
- Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Huizhao Liao
- Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jinru Zhu
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Chaoyu Wang
- Department of Respiratory and Critical Care Medicine, Taishan Hospital of Traditional Chinese Medicine, Jiangmen, Guangdong, China
| | - Zhenzhen Zheng
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Riken Chen
- Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yang Wang
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Chongqing Liang Jiang New Area, Chongqing, China
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Han J, Cheng HL, Bi LN, Molasiotis A. Mind-Body Therapies for Sleep Disturbance among Patients with Cancer: A Systematic Review and Meta-analysis. Complement Ther Med 2023; 75:102954. [PMID: 37244384 DOI: 10.1016/j.ctim.2023.102954] [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: 12/19/2022] [Revised: 04/17/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023] Open
Abstract
OBJECTIVE s: To assess whether mind-body therapies (MBTs) are effective for relieving sleep disturbance among patients with cancer. DESIGN Systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS Seven English electronic databases were searched from the date of inception to September 2022. All RCTs that included adults (≥18 years) who were treated with mindfulness, yoga, qigong, relaxation, and hypnosis were screened. The outcome was subjective and/or objective sleep disturbance.The revised Cochrane tool (RoB 2.0) was applied to evaluate the risk of bias. The RevMan software was applied to assessed each outcome according different control groups and assessment time points. Subgroup analyses were performed according to different categories of MBTs. RESULTS Sixty-eight RCTs (6339 participants) were identified. After requesting for missing data from corresponding authors of included RCTs, 56 studies (5051 participants) were included in the meta-analysis. The meta-analysis showed a significant immediate effect of mindfulness, yoga, relaxation, and hypnosis on subjective sleep disturbance, compared with usual care or wait list control, and the effect of mindfulness lasted at least 6 months. For objective sleep outcomes, we observed significant immediate effects of yoga on wake after sleep onset and of mindfulness on sleep onset latency and total sleep time. Compared with active control interventions, MBTs had no significant effect on sleep disturbance. CONCLUSIONS Mindfulness, yoga, relaxation, and hypnosis were effective in sleep disturbance severity reduction among patients with cancer at post-intervention, and the effect of mindfulness lasted at least 6 months. Future MBTs studies should apply both objective and subjective sleep measurement tools.
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Affiliation(s)
- Jing Han
- School of Nursing, Xuzhou Medical University, Xuzhou, China.
| | - Hui-Lin Cheng
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Liu-Na Bi
- School of Nursing, Xuzhou Medical University, Xuzhou, China.
| | - Alex Molasiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; College of Arts, Humanities and Education, University of Derby, Derby, UK.
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Warth M, Stoffel M, Koehler F, Bardenheuer HJ, Kessler J, Ditzen B. Characteristics of salivary cortisol and alpha-amylase as psychobiological study outcomes in palliative care research. BMC Palliat Care 2022; 21:226. [PMID: 36550454 PMCID: PMC9773457 DOI: 10.1186/s12904-022-01085-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/25/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Psychosocial interventions are rapidly emerging in palliative care. However, randomized trials often fail to provide evidence for their effectiveness with regard to patient-reported outcomes. Stress biomarkers could complement self-report data, but little is known about their feasibility, acceptance, and interpretability. METHODS Therefore, we designed a randomized crossover trial in which 42 patients in a palliative care unit participated in both a brief mindfulness intervention (MI) and a resting state control condition (CC) on two consecutive afternoons. On each day, we collected four saliva samples in 20-min intervals using Salivettes© to determine salivary cortisol (sCort) and alpha-amylase (sAA) concentration levels. At all measurement points, self-rated well-being and stress as well as cardiovascular markers were assessed. Baseline measurements further included self-rated quality of life and clinician-rated functional status. RESULTS 78.6% of the patients provided the maximum number of 8 saliva samples and 62.2% reported no subjective difficulties with the sampling procedures. 66.6% (sCort) and 69.6% (sAA) of all possible samples were finally included in the analysis. Xerostomia and nausea were the main reasons for missing data. Higher sCort levels were associated with higher heart rate and lower quality of life, functional status, and heart rate variability. Corticosteroid and sedative medication as well as time since last meal were identified as potential confounders. Regarding reactivity to the MI, we found an overall decrease in sCort levels over time (b = -.03, p = .01), but this effect did not differ significantly between the study conditions (b = .03, p = .21). sAA levels were higher in men than in women. Trajectories over time did not significantly differ between the two conditions (b = -.02, p = .80) and associations with other stress and health-related constructs were weak. CONCLUSIONS Findings indicate that sCort might serve as a psychobiological outcome in future palliative care trials. However, future research should refine the exact measurement and conceptualization strategies for sCort in palliative care research. High attrition rates should be expected in patients with xerostomia or nausea. TRIAL REGISTRATION Registered at the German Clinical Trials Registry (DRKS00013135) at 04/12/2017.
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Affiliation(s)
- Marco Warth
- grid.5253.10000 0001 0328 4908Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Ruprecht-Karls-University Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany ,grid.466188.50000 0000 9526 4412School of Therapeutic Sciences, SRH University Heidelberg, Ludwig-Guttmann-Straße 6, 66120 Heidelberg, Germany
| | - Martin Stoffel
- grid.5253.10000 0001 0328 4908Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Ruprecht-Karls-University Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany
| | - Friederike Koehler
- grid.5253.10000 0001 0328 4908Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Ruprecht-Karls-University Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany
| | - Hubert J. Bardenheuer
- grid.5253.10000 0001 0328 4908Department of Anesthesiology, University Hospital Heidelberg, Im Neuenheimer Feld 131, 69120 Heidelberg, Germany
| | - Jens Kessler
- grid.5253.10000 0001 0328 4908Department of Anesthesiology, University Hospital Heidelberg, Im Neuenheimer Feld 131, 69120 Heidelberg, Germany
| | - Beate Ditzen
- grid.5253.10000 0001 0328 4908Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Ruprecht-Karls-University Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany
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Yoga, Meditation, Breathing Exercises, and Inflammatory Biomarkers with Possible Implications in COVID-19: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3523432. [PMID: 36248417 PMCID: PMC9568285 DOI: 10.1155/2022/3523432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/01/2022] [Indexed: 01/08/2023]
Abstract
Introduction COVID-19, a multisystem disease, has implications for various immunity and infection biomarkers. Yoga (Y), meditation (M), and pranayama (P), and their combinations have shown positive changes on those biomarkers among other than COVID-19 patients and healthy people. So, we aimed to document the evidence of possible implication in a systematic way. Materials and Methods We screened 84 full texts, published in the last ten years, from three databases, from which only 44 met the eligibility criteria, and then extracted the data related to demographic characteristics, intervention, results, and strengths and limitations in two MS-Excel grids, and then presented them in tables and figures. Furthermore, we carried out meta-analysis including subgroup and sensitivity analysis using a random effects model of 11 RCTs and reported the mean difference, heterogeneity, and p value with 95% CI and presented them with forest and funnel plots and the tables. Results Twenty-five biomarkers of 4023 participants (range, 15-413) from 13 countries, healthy and clinical, from both sexes above 18 years, and from mainly clinical settings, were reported. YMP intervention, in solitary or in different possible combinations with varied durations among clinical and pregnant (range, 960-4800 minutes) and healthy (960-8400 minutes, excluding two studies of 20 minutes only) participants, was reported. It was revealed that 25 biomarkers, nine among the apparently healthy, 14 among the patients, and two among the pregnant, changed favourably (p < 0.05). Furthermore, either in meta- or subgroup-analysis, mean differences of IL-6 (-1.44 pg/ml) (95% CI) (-2.33, -0.55), (p = 0.002, I 2 = 82%), Cortisol (-40.75 pg/ml) (95% CI) (-64.13, -17.38), (p = 0.0006, I 2 = 87%), and TNF-α (-3.40 pg/ml) (95% CI) (-4.83, -1.98), (p < 0.0001, I 2 = 79%) showed statistically significant changes. Nonetheless, considerable heterogeneity and publication bias were observed among the studies. Conclusion Although more than two dozens of biomarkers in individual studies showed favourable changes, only IL-6, Cortisol, and TNF-α produced significant combined results, even then with much less certainty. Further meta-analysis of biomarkers of COVID-19 patients is highly recommended. Registration: CRD42021283894.
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Kaje KC, Dsilva F, T. L, TS S, D'Souza C, Kumar S. A Systematic Review Protocol on the Effect of Yoga Intervention on Inflammatory Biomarkers among Women with Breast Cancer. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0042-1755583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractA systematic review protocol acts as a guide in the review process to prevent the introduction of bias, maintain transparency and allows reproducibility. Yoga intervention had been experimented on various health aspects such as physical functioning, health-related quality of life, psychosocial and emotional well-being among breast cancer populations, and the findings have been very encouraging. Studies are being performed on the effect of yoga intervention(s) at the molecular level by assessing the inflammatory cytokines and also stress hormones such as cortisol. This protocol is developed to escort in evaluating studies that have been performed on evidence-based yoga intervention at the level of cancer microenvironment, in women diagnosed with breast cancer, by assessing the inflammatory biomarkers and cortisol level, a primary stress marker, and a potent influence of inflammation. The findings will elucidate the picture of the cancer microenvironment as a result of yoga intervention.
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Affiliation(s)
- Kaini Cecilia Kaje
- Department of Nursing, Nitte Usha Institute of Nursing Sciences, Nitte (Deemed to be University), Mangalore, Karnataka India
| | - Fatima Dsilva
- Department of Nursing, Nitte Usha Institute of Nursing Sciences, Nitte (Deemed to be University), Paneer, Deralakatte, Mangalore, Karnataka, India
| | - Latha T.
- Department of Nursing, College of Nursing, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Sanal TS
- Department of Biostatistics; JDC Hospital & Research Centre, Trivandrum, India
| | - Caren D'Souza
- Department of Surgery, K.S. Hegde Medical Academy, Nitte (Deemed to be University) Mangalore, Karnataka, India
| | - Shishir Kumar
- Department of Psychiatry K.S. Hegde Medical Academy, Nitte (Deemed to be University) Mangalore, Karnataka, India
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Pluto-Pradzynska A, Pluto-Pradzynska K, Frydrychowicz M, Lagiedo-Zelazowska M, Owoc J, Benjamin S, Au TY, Jaracz K, Dworacki G, Wysocki J, Wasik J. Are yoga and physical activity determinants of quality of life in Polish adults? a cross-sectional study. BMJ Open 2022; 12:e059658. [PMID: 36167364 PMCID: PMC9516201 DOI: 10.1136/bmjopen-2021-059658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Yoga is an ancient form of physical activity (PA) that encompasses meditation, stretching and breathing techniques. Although the benefits of PA and associated lifestyle interventions are clear, we here addressed the paucity of evidence regarding the specific relationship between yoga and quality of life (QOL) in adults in Poland. We hypothesised that participation in PA and yoga could result in a positive impact on QOL. DESIGN Cross-sectional, self-administered questionnaire-based survey. Both the quantitative and qualitative variables were statistically compared. Multivariate analyses were performed using linear regression. Results were determined based on age, sex and education level; a p<0.05 was considered significant. SETTING Questionnaires were delivered to participants online, at high schools and universities, and in elderly communities in Poland. PARTICIPANTS 714 polish citizens aged over 18 participated in the study; there are no specific entry and exclusion criteria besides age. RESULTS Statistically significant differences (p<0.05) were observed between the QOL of the physically active group (PAG) and non-PAG (N-PAG). Meanwhile, yoga practice was revealed to have a significant effect on QOL; QOL was found to be statistically higher (p<0.001) in the PAG with yoga (PAG-Y) (4.29±0.66) than in the N-PAG (3.83±0.92) and PAG without yoga (4.07±0.68). CONCLUSIONS The study shows that both regular PA and yoga practices could improve QOL; however, PAG-Y produced higher QOL scores than PA of other types. This outcome may be explained by the impact of physiological and psychological aspects within yoga practice. These results suggest that this unique combination impacts health more positively than other kinds of PA alone.
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Affiliation(s)
- Agnieszka Pluto-Pradzynska
- Department of Immunology, Chair of Pathomorphology and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
| | - Karolina Pluto-Pradzynska
- Department of Immunology, Chair of Pathomorphology and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
- Faculty of Educational Studies, Adam Mickiewicz University, Poznan, Poland
| | - Magdalena Frydrychowicz
- Department of Immunology, Chair of Pathomorphology and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
| | - Malgorzata Lagiedo-Zelazowska
- Department of Immunology, Chair of Pathomorphology and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jakub Owoc
- Department of Immunology, Chair of Pathomorphology and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
| | - Shamiram Benjamin
- Department of Immunology, Chair of Pathomorphology and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
| | - Tsz Yuen Au
- Department of Immunology, Chair of Pathomorphology and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
| | - Krystyna Jaracz
- Department of Neurological Nursing, Poznan University of Medical Sciences, Poznan, Poland
| | - Grzegorz Dworacki
- Department of Immunology, Chair of Pathomorphology and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Wysocki
- Chair of Health Prevention, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Wasik
- Department of Kinesiology and Health Prevention, Faculty of Health Sciences, Jan Dlugosz University in Czestochowa, Czestochowa, Poland
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11
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Koehler F, Kessler J, Stoffel M, Weber M, Bardenheuer HJ, Ditzen B, Warth M. Psychoneuroendocrinological effects of music therapy versus mindfulness in palliative care: results from the 'Song of Life' randomized controlled trial. Support Care Cancer 2022; 30:625-634. [PMID: 34355279 PMCID: PMC8636432 DOI: 10.1007/s00520-021-06435-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/12/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE Although research on psychosocial interventions in palliative care provided evidence for their effectiveness regarding patient-reported outcomes, few studies have examined their psychobiological effects yet. Therefore, the purpose of the present work as part of an overarching study was to investigate differential effects of music therapy versus mindfulness on subjective distress and both neuroendocrine and autonomic stress biomarkers. METHODS A total of 104 patients from two palliative care units were randomly assigned to three sessions of either music therapy or mindfulness. Before and after the second session (completed by 89 patients), participants rated their momentary distress and provided three saliva samples for cortisol and α-amylase analysis. Furthermore, photoplethysmography recordings were continuously assessed to calculate mean heart rate and heart rate variability. Data were analyzed using multilevel modeling of all available data and sensitivity analysis with multiply imputed data. RESULTS Between 67 and 75% of the maximally available data points were included in the primary analyses of psychobiological outcomes. Results showed a significant time*treatment effect on distress (b = - 0.83, p = .02) indicating a greater reduction in the music therapy group. No interaction effects were found in psychobiological outcomes (all p > .05), but multilevel models revealed a significant reduction in cortisol (b = - 0.06, p = .01) and mean heart rate (b = - 7.89, p = .05) over time following either intervention. CONCLUSION Findings suggest a beneficial effect music therapy on distress while no differential psychobiological treatment effects were found. Future studies should continue to investigate optimal stress biomarkers for psychosocial palliative care research. TRIAL REGISTRATION German Clinical Trials Register (DRKS)-DRKS00015308 (date of registration: September 7, 2018).
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Affiliation(s)
- Friederike Koehler
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115, Heidelberg, Germany
- Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Jens Kessler
- Center of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Martin Stoffel
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115, Heidelberg, Germany
- Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Martin Weber
- Interdisciplinary Palliative Care Unit, III. Department of Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Hubert J Bardenheuer
- Center of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115, Heidelberg, Germany
- Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Marco Warth
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115, Heidelberg, Germany.
- Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.
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12
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Kumar S, Venu A, Jaya MH. Effect of yoga mudras in improving the health of users: A precautionary measure practice in daily life for resisting the deadly COVID-19 disease. LESSONS FROM COVID-19 2022. [PMCID: PMC9347266 DOI: 10.1016/b978-0-323-99878-9.00001-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
COVID-19 is a deadly disease that affected millions of people around the world. Vaccines are presently being made available for curtailing the disease. However, many people lost their lives because of breathing problems associated with the virus infection. Science and technology have advanced a lot in the identification of the COVID-19 virus through RT-PCR tests and CT imaging. The ashtanga yoga focuses on the moral, intellectual, and health aspect improvement of individuals. This study notes that the role of Yoga (mudras) is inevitable in improving the health conditions of both the infected and noninfected persons. The effects of mudras in health care were scientifically proven, and many reputed works are there highlighting the merits of mudras. To this end, this research work proposed a set of mudras with a breathing exercise that focuses on the improvement of immunity and minimizes respiratory issues. A consistent practice of mudras with a breathing exercise for 30 min each (morning and evening) paves the way toward a healthy life. The breathing exercise proposed in this research work is Nadi Shuddi Pranayama in Virasana position and the following mudras: garuda mudra, aswini mudra, adhi mudra, prana mudra, bronchial mudra, and apana vayu mudra. The chapter comprises of the following: introduction to yoga and its scientific evidence in improving health care, related works in improving health care by mudras, and a universal practice system comprising of breathing exercise and mudras for resisting COVID-19. In theory, the outcome of this chapter focuses on the holistic improvement of health care of people particularly during crises such as the COVID-19 pandemic.
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13
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Faravel K, Huteau ME, Jarlier M, de Forges H, Meignant L, Senesse P, Norton J, Jacot W, Stoebner A. Importance of Patient Education for At-home Yoga Practice in Women With Hormonal Therapy-induced Pain During Adjuvant Breast Cancer Treatment: A Feasibility Study. Integr Cancer Ther 2021; 20:15347354211063791. [PMID: 34939444 PMCID: PMC8725037 DOI: 10.1177/15347354211063791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Osteo-articular pain (OAP) is experienced by approximately 50% of women under
hormonal therapy (HT) for breast cancer (BC), which increases the risk for
therapy discontinuation. This study was aimed to assess benefits of yoga
practice combined with patient education (PE) for at-home practice by
evaluating feasibility among BC patients under HT and measuring OAP,
flexibility and satisfaction. Methods Feasibility was evaluated by patient adherence as accomplishment of at least
4 out of 6 supervised yoga-PE sessions along with 70% or more at-home yoga
sessions. Intervention (12 weeks) included two 6-weeks periods: P1
comprising one 90-minutes supervised yoga-PE session/week and 15-minutes
daily at-home yoga and P2, daily autonomous at-home yoga sessions.
Evaluations (at inclusion and by the end of each period) consisted in
assessment of OAP on Visual Analog Scale (VAS), forward flexibility (cm) and
patient satisfaction on Likert (0-10 points) scale. Results Between September 2018 and May 2019 we included 24 patients of median
53 years (range 36-72). Feasibility was validated by 83% successful
adherence rate. Pain was significantly reduced from median VAS of 6 [range
4-10] to 4 [range 0-7] at the end of both P1 and P2
(p < 0.01), albeit with no difference between P1 and P2.
Forward flexibility improved by a median gain of 8 cm (end of P2) and median
satisfaction score of 10/10 [range 8-10]. Conclusion Combined physiotherapy-yoga-PE intervention is a feasible strategy to
increase at-home yoga practice with potential benefit on pain, flexibility,
and satisfaction, thus prompting further evaluations in larger randomized
multicenter trials. ClinicalTrials.gov NCT04001751
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Affiliation(s)
- Kerstin Faravel
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France
| | - Marie-Eve Huteau
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France
| | - Marta Jarlier
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France
| | - Hélène de Forges
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France
| | - Laetitia Meignant
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France
| | - Pierre Senesse
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France.,University of Montpellier, INSERM UA11, U1194, U1298, Montpellier, France
| | - Joanna Norton
- University of Montpellier, INSERM UA11, U1194, U1298, Montpellier, France
| | - William Jacot
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France.,University of Montpellier, INSERM UA11, U1194, U1298, Montpellier, France
| | - Anne Stoebner
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France.,University of Montpellier, INSERM UA11, U1194, U1298, Montpellier, France
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14
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Nagarathna R, Kumar S, Anand A, Acharya IN, Singh AK, Patil SS, Latha RH, Datey P, Nagendra HR. Effectiveness of Yoga Lifestyle on Lipid Metabolism in a Vulnerable Population-A Community Based Multicenter Randomized Controlled Trial. MEDICINES 2021; 8:medicines8070037. [PMID: 34357153 PMCID: PMC8303653 DOI: 10.3390/medicines8070037] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/13/2021] [Accepted: 06/29/2021] [Indexed: 01/09/2023]
Abstract
Background: Dyslipidemia poses a high risk for cardiovascular disease and stroke in Type 2 diabetes (T2DM). There are no studies on the impact of a validated integrated yoga lifestyle protocol on lipid profiles in a high-risk diabetes population. Methods: Here, we report the results of lipid profile values of 11,254 (yoga 5932 and control 5322) adults (20–70 years) of both genders with high risk (≥60 on Indian diabetes risk score) for diabetes from a nationwide rural and urban community-based two group (yoga and conventional management) cluster randomized controlled trial. The yoga group practiced a validated integrated yoga lifestyle protocol (DYP) in nine day camps followed by daily one-hour practice. Biochemical profiling included glycated hemoglobin and lipid profiles before and after three months. Results: There was a significant difference between groups (p < 0.001 ANCOVA) with improved serum total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein in the yoga group compared to the control group. Further, the regulatory effect of yoga was noted with a significant decrease or increase in those with high or low values of lipids, respectively, with marginal or no change in those within the normal range. Conclusion: Yoga lifestyle improves and regulates (lowered if high, increased if low) the blood lipid levels in both genders of prediabetic and diabetic individuals in both rural and urban Indian communities.
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Affiliation(s)
- Raghuram Nagarathna
- Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bengaluru 560105, India; (A.K.S.); (S.S.P.); (H.R.N.)
- Correspondence: (R.N.); (A.A.)
| | - Saurabh Kumar
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India;
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India;
- Centre for Mind Body Medicine, PGIMER, Chandigarh 160012, India
- Centre for Cognitive Science and Phenomenology, Panjab University, Chandigarh 160014, India
- Correspondence: (R.N.); (A.A.)
| | - Ishwara N. Acharya
- Central Council for Research in Yoga & Naturopathy (CCRYN), Delhi 110058, India;
| | - Amit Kumar Singh
- Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bengaluru 560105, India; (A.K.S.); (S.S.P.); (H.R.N.)
| | - Suchitra S. Patil
- Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bengaluru 560105, India; (A.K.S.); (S.S.P.); (H.R.N.)
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15
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Yeun YR, Kim SD. Effects of yoga on immune function: A systematic review of randomized controlled trials. Complement Ther Clin Pract 2021; 44:101446. [PMID: 34265577 DOI: 10.1016/j.ctcp.2021.101446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/07/2021] [Accepted: 07/09/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This systematic review attempts to confirm the added evidence to assess the effect of yoga on immune function. METHODS The Cochrane Library, Embase, PsycINFO, PubMed, and Web of Science electronic databases were searched according to the PRISRMA method to identify randomized controlled trials (RCTs) on the immunological effects of yoga published in the English language from January 1, 2017, to December 31, 2020. This review could only be descriptively summarized because of heterogeneity of the included RCTs. RESULTS Eleven potential trials were identified and included in this review. Quality appraisal of included trials ranged from 3 for unclear risk of bias and 8 for high risk of bias. There is evidence from 11 RCTs that yoga may have favorable effects for reducing the levels of anti-inflammatory markers. CONCLUSIONS Yoga may be used as a complementary intervention for clinical populations or healthy individuals.
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Affiliation(s)
- Young-Ran Yeun
- Department of Nursing, College of Health Science, Kangwon National University, 346 Hwangjo-gil, Dogye-eup, Samcheok-si, Gangwon-do, 25949, Republic of Korea
| | - Sang-Dol Kim
- Department of Nursing, College of Health Science, Kangwon National University, 346 Hwangjo-gil, Dogye-eup, Samcheok-si, Gangwon-do, 25949, Republic of Korea.
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16
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Tucker JA, Osann K, Hsieh S, Wahi A, Monk BJ, Wenzel L, Nelson EL. Longitudinal Changes in Sleep: Associations with Shifts in Circulating Cytokines and Emotional Distress in a Cancer Survivor Population. Int J Behav Med 2021; 28:140-150. [PMID: 33598780 PMCID: PMC7925505 DOI: 10.1007/s12529-020-09950-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Sleep disturbances are associated with numerous mood disorders. Similarly, anxiety and depression are associated with modulation of the psychoneuroimmune (PNI) axis. This study hypothesized that changes in both monitored and self-reported measures of sleep would relate to changes in circulating cytokine levels in an emotionally distressed population of cervical cancer survivors. METHODS Biospecimens, patient-reported outcome (PRO) measures, and actigraphy were collected from cervical cancer survivors enrolled in a biobehavioral clinical trial. Longitudinal changes over a 4-month period were examined. Sleep time measured by actigraphy and PRO were analyzed for correlative changes with emotional distress and serum cytokines (n = 71). RESULTS Longitudinal change in the actigraph measure of sleep time was inversely associated with changes in depression and anxiety (test for linear trend, p = 0.02 and p = 0.05 respectively), as well as acute-phase response/pro-inflammatory cytokines (test for linear trend, p = 0.003, interleukin (IL)-2; 0.022, IL-1β; 0.0002, IL-6; and 0.049, tumor necrosis factor α). Conversely, changes in self-reported sleep problems were related to an increase in depression and anxiety (p = 0.001 and p = 0.01 respectively), the T helper 2 (Th2) cytokine IL-5 (p = 0.027), and the counter-regulatory cytokine IL-10 (0.016). CONCLUSION This study showed that an increase in sleep time or decrease in sleep problems corresponded with a reduction in self-reported emotional distress and attenuation of pro-inflammatory, Th2, and counter-regulatory cytokines. Our results support sleep measurement as a meaningful biobehavioral variable in cancer survivorship. This study also indicates that sleep investigators should be aware that choice of methodology might influence concordance with different classes of immune parameters.
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Affiliation(s)
- Jo A. Tucker
- Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, CA USA
| | - Kathryn Osann
- Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, CA USA
- Chao Family Comprehensive Cancer Center, University of California, Irvine, CA USA
| | - Susie Hsieh
- Department of Medicine, Division of General Internal Medicine, University of California, Irvine, CA USA
| | - Aditi Wahi
- Department of Medicine, Division of General Internal Medicine, University of California, Irvine, CA USA
| | - Bradley J. Monk
- Arizona Oncology, US Oncology Network, University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix, AZ USA
| | - Lari Wenzel
- Chao Family Comprehensive Cancer Center, University of California, Irvine, CA USA
- Department of Medicine, Division of General Internal Medicine, University of California, Irvine, CA USA
- Program in Public Health, University of California, Irvine, CA USA
| | - Edward L. Nelson
- Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, CA USA
- Department of Medicine, Division of General Internal Medicine, University of California, Irvine, CA USA
- Institute for Immunology, University of California, Irvine, CA 92617 USA
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17
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Özer Z, Bahçecioğlu Turan G, Aksoy M. The effects of yoga on dyspnea, sleep and fatigue in chronic respiratory diseases. Complement Ther Clin Pract 2021; 43:101306. [PMID: 33545575 DOI: 10.1016/j.ctcp.2021.101306] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/12/2020] [Accepted: 01/14/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE This study was carried out to find out the effects of yoga applied to chronic respiratory disease patients on dyspnea, sleep quality and fatigue. MATERIAL AND METHOD The study was conducted between May and August 2020 as a randomized controlled study. 'Personal Information Form', 'Respiratory Functions Monitoring Form', 'COPD and Asthma Fatigue Scale (CAFS), "Asthma and COPD Sleep Impact Scale (CASIS)" and Modified Medical Research Council Dyspnea Scale (mMRC) were used in data collection. RESULTS When the post-test mean scores of the patients in the experimental and control group were compared, it was found that CAFS, CASIS and mMRC mean scores of the patients in the experimental group decreased positively compared to the patients in the control group and the difference between was found to be statistically significant (p < 0.05). CONCLUSION Yoga has been found to reduce the severity of dyspnea and fatigue and improve sleep quality in chronic respiratory diseases.
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Affiliation(s)
- Zülfünaz Özer
- Department of Nursing, Faculty of Health Sciences, Istanbul Sabahattin Zaim University, Istanbul, Turkey.
| | | | - Meyreme Aksoy
- Department of Nursing, Faculty of Health Science Siirt University, Siirt, Turkey.
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18
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A scoping review of studies exploring leisure-time physical activity in adults diagnosed with advanced cancer. Palliat Support Care 2020; 19:615-630. [PMID: 33308368 DOI: 10.1017/s1478951520001327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Despite improving survival rates, people with advanced cancer face several physical and psychosocial concerns. Leisure-time physical activity (LPA) has been found to be beneficial after cancer diagnosis, but little is known about the current state of research exploring LPA in advanced cancer. Our objectives were to (a) map the literature examining LPA in people with advanced cancer, (b) report on the terms used to describe the advanced cancer population within the literature, and (c) examine how the concept of LPA is operationalized within the literature. METHOD Our scoping review followed Arksey and O'Malley's methodological framework. We performed a search of 11 electronic databases and supplementary sources (February 2018; database search updated January 2020). Two reviewers independently reviewed and selected articles according to the inclusion criteria: English-language journal articles on original primary research studies exploring LPA in adults diagnosed with advanced cancer. Descriptive and thematic analyses were performed. RESULTS Ninety-two articles met our criteria. Most included studies were published in the last decade (80%) and used quantitative methods (77%). Many study populations included mixed (40%), breast (21%), or lung (17%) cancers. Stages 3-4 or metastatic disease were frequently indicated to describe study populations (77%). Several studies (68%) described LPA programs or interventions. Of these, 78% involved structured aerobic/resistance exercise, while 16% explored other LPA types. SIGNIFICANCE OF RESULTS This review demonstrates a recent surge in research exploring LPA in advanced cancer, particularly studies examining exercise interventions with traditional quantitative methods. There remains insufficient knowledge about patient experiences and perceptions toward LPA. Moreover, little is known about other leisure activities (e.g., Tai Chi, dance, and sports) for this population. To optimize the benefits of LPA in people with advanced cancer, research is needed to address the gaps in the current literature and to develop personalized, evidence-based supportive care strategies in cancer care.
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19
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Borgi M, Collacchi B, Ortona E, Cirulli F. Stress and coping in women with breast cancer:unravelling the mechanisms to improve resilience. Neurosci Biobehav Rev 2020; 119:406-421. [PMID: 33086128 DOI: 10.1016/j.neubiorev.2020.10.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 12/15/2022]
Abstract
Breast cancer diagnosis, surgery, adjuvant therapies and survivorship can all be extremely stressful. In women, concerns about body image are common as a result of the disease and can affect interpersonal relationships, possibly leading to social isolation, increasing the likelihood for mood disorders. This is particularly relevant as women are at greater risk to develop anxiety and depressive symptoms in response to highly stressful situations. Here we address the mechanisms and the pathways activated as a result of stress and contributing to changes in the pathophysiology of breast cancer, as well as the potential of stress management factors and interventions in buffering the deleterious effects of chronic stress in a gender perspective. An improved understanding of the biological mechanisms linking stress-management resources to health-relevant biological processes in breast cancer patients could reveal novel therapeutic targets and help clarifying which psychosocial interventions can improve cancer outcomes, ultimately offering a unique opportunity to improve contemporary cancer treatments.
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Affiliation(s)
- Marta Borgi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Barbara Collacchi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Elena Ortona
- Center for Gender Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Francesca Cirulli
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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Salwa H, Nair PMK. Raising burden of non-communicable diseases: importance of integrating Yoga and Naturopathy at primary care level. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 18:271-278. [PMID: 32745069 DOI: 10.1515/jcim-2017-0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 04/18/2020] [Indexed: 11/15/2022]
Abstract
Primary health care is a vital component in health care delivery. Non-communicable diseases (NCD's) are rising like a major threat to human survival, which is expected to account for 75% of the total mortality by 2030. Lifestyle and behavioural changes are reckoned as the way ahead. Yoga and Naturopathy, a drugless system of medicine has intersecting paradigms which addresses all planes of health effectively. Yoga and Naturopathy through its holistic approach educate and make the people responsible for their own health. It has shown its efficacy in alleviating and preventing various NCD's. A systematic approach should be initiated, which can channelize the integration of Yoga and Naturopathy at the primary care level considering its cost-effectiveness and efficacy over NCD's.
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Affiliation(s)
- Hyndavi Salwa
- Research Officer, National Institute of Naturopathy, Government of India, Pune, India
| | - Pradeep M K Nair
- Director, Indian Academy for Scientific Writing and Research, Pune, India
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Moon SY, Jerng UM, Kwon OJ, Jung SY, Lee JY, Yoon SW, Shin WC, Byun JI, Lee JH. Comparative Effectiveness of Cheonwangbosimdan (Tian Wang Bu Xin Dan) Versus Cognitive-Behavioral Therapy for Insomnia in Cancer Patients: A Randomized, Controlled, Open-Label, Parallel-Group, Pilot Trial. Integr Cancer Ther 2020; 19:1534735420935643. [PMID: 32627605 PMCID: PMC7338643 DOI: 10.1177/1534735420935643] [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: 11/17/2022] Open
Abstract
Cancer patients have a 2 times higher prevalence of insomnia than healthy
populations and cancer-related insomnia has received minimal attention while
insomnia can aggravate the rehabilitation of cancer patients. Cheonwangbosimdan
is a Korean herbal medicine generally used to relieve sleep deprivation,
however, few studies presented the effects of Cheonwangbosimdan on
cancer-related insomnia. The purpose of study is to examine the feasibility of
Cheonwangbosimdan treatments for cancer patients. Twenty-two participants were
allocated into a Cheonwangbosimdan or cognitive-behavioral therapy for insomnia
(CBT-I) control group by equal number. The intervention group took
Cheonwangbosimdan liquid once in a day and attend visits once a week for 4
weeks. The CBT-I group underwent individualized behavioral therapy 4 times in 4
weeks. The primary outcome is changes in the Insomnia Severity Index (ISI) from
baseline to the end of the trial. Responses to the Pittsburgh Sleep Quality
Index (PSQI), Epworth Sleepiness Scale (ESS), Zung Self-Rating Anxiety Scale
(SAS), Brief Fatigue Inventory (BFI), Euroqol-5 Dimensions-5 Levels (EQ-5D-5L),
and Eastern Cooperative Oncology Group Performance Status (ECOG-PS) were
secondary outcomes used to evaluate the quality of sleep. Outcomes were measured
at a follow-up visit (visit 5) in the fifth week of the trial. There is no
difference between 2 groups, but both groups showed tendency to alleviate cancer
insomnia symptoms. SAS-K showed significant difference between the 2 groups (P
< .001), as treatment group score was highly lowered than control group
score. The study can contribute to more attentive care for insomnia in cancer
patients.
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Affiliation(s)
- Sun-Young Moon
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.,University of Science and Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Ui Min Jerng
- Sang-ji University Korean Medicine Hospital, Wonju, Republic of Korea
| | - O-Jin Kwon
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - So-Young Jung
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jee Young Lee
- Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.,Kyung Hee University, Seoul, Republic of Korea
| | - Seong Woo Yoon
- Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.,Kyung Hee University, Seoul, Republic of Korea
| | - Won-Chul Shin
- Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Jung-Ick Byun
- Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Jun-Hwan Lee
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.,University of Science and Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Guerra PC, Santaella DF, D'Almeida V, Santos-Silva R, Tufik S, Len CA. Yogic meditation improves objective and subjective sleep quality of healthcare professionals. Complement Ther Clin Pract 2020; 40:101204. [PMID: 32891281 DOI: 10.1016/j.ctcp.2020.101204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/15/2020] [Accepted: 05/26/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Our aim was to evaluate the impact of yogic meditation in sleep quality of healthy pediatric healthcare professionals. METHOD Subjects were randomized into a meditation group (MG, n = 32), who attended a yogic meditation class held for eight weeks, or a control group (CG, n = 32). Polysomnography (PSG) and Pittsburgh Sleep Quality Index (PSQI) scores were determined at baseline and after eight weeks. RESULTS The PSQI overall score was lower (p = 0.024) in the MG. Reported sleep latency (p = 0.046) and MG sleep latency (p = 0.028) were lower in the MG at eight weeks. PSG showed a time effect (p = 0.020) on decreasing minutes of wake after sleep onset in the MG. There were strong and significant correlations between PSG and PSQI variables. There was a significant time effect on heart rate (p = 0.001) in the MG. CONCLUSION Yogic meditation may be used as an integrative health tool to foster improvements in the health-related aspects of healthcare professionals' lives. TRIAL REGISTRATION CinicalTrials.gov identifier: NCT02947074; trial registry name: Meditation Practice in Pediatric Healthcare Professionals: A Randomized Controlled Clinical Trial.
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Affiliation(s)
- Priscilla Caetano Guerra
- Pediatric Rheumatology Unit, Department of Paediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Borges Lagoa 802, CEP 04038-001, São Paulo, Brazil
| | - Danilo F Santaella
- Sports Center, University of São Paulo (CEPEUSP), Rua Rio Doce 27, CEP 06350-030, Brazil
| | - Vania D'Almeida
- Department of Psychobiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros 925, 3rd, Floor, CEP 04024-002, São Paulo, Brazil
| | - Rogerio Santos-Silva
- Department of Psychobiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros 925, 3rd, Floor, CEP 04024-002, São Paulo, Brazil
| | - Sergio Tufik
- Department of Psychobiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros 925, 3rd, Floor, CEP 04024-002, São Paulo, Brazil
| | - Claudio Arnaldo Len
- Pediatric Rheumatology Unit, Department of Paediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Borges Lagoa 802, CEP 04038-001, São Paulo, Brazil.
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Hegde D, Bhargav PH, Bhargav H, Babu H, Varsha KA, Raghuram N. Feasibility and Pilot Efficacy Testing of Integrated Yoga and Shirodhara (Ayurvedic Oil-Dripping) Intervention on Clinical Symptoms, Cognitive Functions and Sleep Quality of Adults with Anxiety Disorder. Int J Yoga 2020; 13:32-41. [PMID: 32030019 PMCID: PMC6937873 DOI: 10.4103/ijoy.ijoy_44_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Beneficial effects of yoga therapy in anxiety disorders (ADs) are known. Traditional texts describe usefulness of Ayurvedic oil-dripping, Shirodhara technique, in relieving anxiety. Thus, present study was planned to assess the feasibility and synergistic value of Shirodhara as an add-on to yoga therapy in adults with AD. Materials and Methods: Thirty adults (males = 14, females = 16) admitted in a residential holistic health care center with an age range of 29.66 ± 6.63 years and diagnosis of one of the ADs (generalized AD, n = 18; social phobia, n = 8; and panic AD, n = 4) as per mini-international neuropsychiatric interview (M. I. N. I. English version 5.0) by a psychiatrist were randomly divided into two groups: (1) integrated yoga-based lifestyle program (YT; n = 15) and (2) YT + Ayurveda (YA; n = 15). Both groups continued to receive conventional treatment and were on stable medications throughout the study period except in cases of emergency. Assessments were done by an independent assessor at baseline and after 2 weeks of intervention for clinical symptoms (HAM-A, State and Trait Anxiety Inventory, and Brief Psychiatric Rating Scale), sleep quality (sleep rating questionnaire), and cognition (Stroop test and digit letter substitution test) using standard validated tools. Parametric tests were applied using SPSS 10.0 to analyze the data. Results: Twelve subjects in yoga group and thirteen subjects in YA group completed the trial. No side effects were reported in any of the groups. Within-group comparisons showed a significant improvement in clinical symptoms, cognition and sleep quality in both the groups. Between-group comparisons showed significantly better scores in Stroop word task for YA group as compared to YT group. Furthermore, there was a trend toward better improvement in sleep quality for YA group. Conclusion: Adding of Shirodhara technique to YT was feasible and may be useful in improving executive memory and sleep quality in adults with ADs.
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Affiliation(s)
- Deepa Hegde
- Division of Yoga and Life Sciences, School of Yoga and Life Sciences, S-VYASA Yoga University, Bengaluru, Karnataka, India
| | - Praerna H Bhargav
- Department of Psychiatry, NIMHANS Integrated Centre of Yoga, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Hemant Bhargav
- Department of Psychiatry, NIMHANS Integrated Centre of Yoga, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Harish Babu
- Department of Kayachikitsa, Sushrutha Ayurvedic Medical College and Hospital, Bengaluru, Karnataka, India
| | - K A Varsha
- Arogyadhama Health Center, S-VYASA Yoga University, Bengaluru, Karnataka, India
| | - Nagarathna Raghuram
- Arogyadhama Health Center, S-VYASA Yoga University, Bengaluru, Karnataka, India
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Tong LQ. Correlation among mental resilience, perceived stress, and sleep quality in elderly patients with functional dyspepsia. Shijie Huaren Xiaohua Zazhi 2019; 27:1391-1395. [DOI: 10.11569/wcjd.v27.i22.1391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Repeated epiodes of functional dyspepsia (FD) in the elderly tend to affect the psychological mood and sleep quality of patients. Sleep disorders and negative psychological mood can affect each other, forming a vicious circle. In this study, the psychological resilience, perceived pressure, and sleep quality of elderly FD patients were investigated, in order to provide important objective evidence for clinical management of this population.
AIM To analyze the correlation among perceived stress, mental resilience, and sleep quality in elderly FD patients.
METHODS One hundred and twenty elderly patients with FD admitted to the Second Hospital of Jinhua City, Zhejiang Province from March 2017 to June 2019 were selected as study subjects, and Pittsburgh sleep quality index (PSQI), perceived stress scale (PSS), and mental resilience scale (CD-RISC-10) were used to analyze the sleep quality, perceived stress, and mental resilience.
RESULTS Mean PSS score was 15.3 ± 4.8, mean mental resilience score was 26.1 ± 6.2, and mean PSQI score was 7.3 ± 2.7. Mean mental resilience scores were negatively correlated with PSS scores and PSQI scores (r = -0.58, -0.41, P < 0.05). PSS scores were positively correlated with PSQI scores (r = 0.33, P < 0.05). PSS scores can positively predict PSQI scores (β= 0.31, P < 0.05), and negatively predict PSQI scores (β= -0.28, P < 0.05).
CONCLUSION Elderly FD patients have poor sleep quality, and perceived pressure and mental resilience are risk factors affecting sleep quality. In clinical practice, sleep can be improved by reducing psychological pressure.
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Affiliation(s)
- Li-Qin Tong
- the Second Hospital of Jinhua City, Jinhua 321016, Zhejiang Province, China
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25
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Abstract
PURPOSE OF REVIEW Psycho-oncology has completed 25 years. There is growing recognition of the psychosocial needs of persons living with cancer and the role of sociocultural factors in addressing the needs. This review addresses the research in developing countries relating to distress associated with living with cancer and psychosocial care. RECENT FINDINGS There is growing recognition of the emotional needs, understanding of the sociocultural aspects of the emotional responses of persons, caregivers, role of resilience and posttraumatic growth and spirituality in cancer care. Psychosocial aspects of cancer are largely influenced by social, economic, cultural, religious and health systems. A number of innovative approaches to care like use of yoga, financial and material support and involvement of caregivers have been implemented. A positive development is the increasing professional attention to document and develop innovative care programmes. SUMMARY A significant proportion of the general population are living with cancer. There are significant psychosocial needs largely influenced by social, economic, cultural, religious aspects of the communities. There are a wide range of interventions from self-care to professional care to address the needs. In developing countries, there is need for longitudinal studies of psycho-social experiences, develop interventions that are culturally appropriate, along with enhanced use of information technology along with evaluation of interventions.
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27
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Pasyar N, Barshan Tashnizi N, Mansouri P, Tahmasebi S. Effect of yoga exercise on the quality of life and upper extremity volume among women with breast cancer related lymphedema: A pilot study. Eur J Oncol Nurs 2019; 42:103-109. [PMID: 31479846 DOI: 10.1016/j.ejon.2019.08.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/05/2019] [Accepted: 08/21/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE This pilot study aimed to evaluate the effect of an 8-weeks-yoga intervention on quality of life and upper extremity edema volume in women with breast cancer related lymphedema. METHODS This was a controlled trial with pre-post design. A total of 40 women with breast cancer related lymphedema were randomly assigned into an intervention or control groups. The intervention group participated in a yoga exercise class for 8 weeks, in a twice a week instructor-led practice and once a week home practice. Outcomes were EORTC QLQ_C30 to measure quality of life, and water displacement volume-meter to measure upper extremity edema volume. The outcomes were evaluated at baseline, 4th and 8th week. Data were analyzed using SPSS. RESULTS Four weeks after the intervention, a significant difference was observed between the groups with respect to role functioning of quality of life (P = 0.03). Eight weeks after the intervention, a significant difference was observed between groups concerning physical and emotional functioning of quality of life (P < 0.05). The changing trend in physical, role, emotional, and cognitive functioning had increased, and in some scales such as fatigue, pain, insomnia, and financial difficulties the scores were reduced in the intervention group. Regarding edema volume, no significant difference was found between both groups on the 4th and 8th week after the intervention (P > 0.05). CONCLUSION As yoga exercise might improve physical, role, and emotional functioning of quality of life as well as reduce fatigue, pain, and insomnia, using this intervention can be suggested amongst women with breast cancer related lymphedema.
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Affiliation(s)
- Nilofar Pasyar
- Community Based Psychiatric Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, 7193613119, Shiraz, Iran.
| | | | - Parisa Mansouri
- Community Based Psychiatric Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, 7193613119, Shiraz, Iran.
| | - Sedigheh Tahmasebi
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Danhauer SC, Addington EL, Cohen L, Sohl SJ, Van Puymbroeck M, Albinati NK, Culos-Reed SN. Yoga for symptom management in oncology: A review of the evidence base and future directions for research. Cancer 2019; 125:1979-1989. [PMID: 30933317 PMCID: PMC6541520 DOI: 10.1002/cncr.31979] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/14/2018] [Accepted: 10/30/2018] [Indexed: 01/23/2023]
Abstract
Because yoga is increasingly recognized as a complementary approach to cancer symptom management, patients/survivors and providers need to understand its potential benefits and limitations both during and after treatment. The authors reviewed randomized controlled trials (RCTs) of yoga conducted at these points in the cancer continuum (N = 29; n = 13 during treatment, n = 12 post-treatment, and n = 4 with mixed samples). Findings both during and after treatment demonstrated the efficacy of yoga to improve overall quality of life (QOL), with improvement in subdomains of QOL varying across studies. Fatigue was the most commonly measured outcome, and most RCTs conducted during or after cancer treatment reported improvements in fatigue. Results also suggested that yoga can improve stress/distress during treatment and post-treatment disturbances in sleep and cognition. Several RCTs provided evidence that yoga may improve biomarkers of stress, inflammation, and immune function. Outcomes with limited or mixed findings (eg, anxiety, depression, pain, cancer-specific symptoms, such as lymphedema) and positive psychological outcomes (such as benefit-finding and life satisfaction) warrant further study. Important future directions for yoga research in oncology include: enrolling participants with cancer types other than breast, standardizing self-report assessments, increasing the use of active control groups and objective measures, and addressing the heterogeneity of yoga interventions, which vary in type, key components (movement, meditation, breathing), dose, and delivery mode.
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Affiliation(s)
- Suzanne C. Danhauer
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Elizabeth L. Addington
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Stephanie J. Sohl
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Marieke Van Puymbroeck
- School of Health Research, College of Behavioral, Social, and Health Sciences, Department of Parks, Recreation, & Tourism Management, Clemson University, Clemson, SC, USA
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Zheng G, Li K, Wang Y. The Effects of High-Temperature Weather on Human Sleep Quality and Appetite. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020270. [PMID: 30669302 PMCID: PMC6351950 DOI: 10.3390/ijerph16020270] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 01/12/2019] [Accepted: 01/16/2019] [Indexed: 11/16/2022]
Abstract
High-temperature weather appears in high frequency, big strength, and long duration in the summer. It is therefore important to study the effects of high-temperature weather on sleep quality and appetite. Ten healthy college students were selected as subjects. The experiment conditions were divided by the daily maximum temperature into 28 °C, 32 °C, 36 °C, and 38 °C. The objective sleep quality was measured by an intelligent sleep monitoring belt, and the subjective sleep quality was measured by a questionnaire survey. The subjective appetites were assessed by a visual analog scale (VAS), and the objective appetites were assessed by the meal weight and the meal time. For sleep quality, the objective results indicated that the sleep quality at 32 °C was the best, followed by 28 °C, while the sleep quality at 36 °C and 38 °C was the worst. Significant effects were mainly reflected in sleep duration and shallow sleep. The subjective results showed that temperature had significant effects on sleep calmness, difficulty in falling asleep, sleep satisfaction, and sleep adequateness. For appetite, the VAS results indicated that high temperatures mainly led to a reduction of appetite at lunch time. The meal weights of lunch were larger than those of supper except for 28 °C, and the meal time of lunch and supper was longer than that of breakfast. The meal time of lunch was longer than that of supper except for 36 °C. This paper can provide a study method and reference data for the sleep quality and appetite of human in high-temperature weather.
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Affiliation(s)
- Guozhong Zheng
- School of Energy, Power and Mechanical Engineering, North China Electric Power University, Baoding 071003, China.
| | - Ke Li
- School of Energy, Power and Mechanical Engineering, North China Electric Power University, Baoding 071003, China.
| | - Yajing Wang
- School of Energy, Power and Mechanical Engineering, North China Electric Power University, Baoding 071003, China.
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Djalilova DM, Schulz PS, Berger AM, Case AJ, Kupzyk KA, Ross AC. Impact of Yoga on Inflammatory Biomarkers: A Systematic Review. Biol Res Nurs 2018; 21:198-209. [PMID: 30572710 DOI: 10.1177/1099800418820162] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Many chronic conditions, including heart disease, cancer, and rheumatoid arthritis, are associated with underlying chronic inflammatory processes. Literature reviews have analyzed a variety of integrative therapies and their relationships with chronic inflammation. This systematic review is unique in reporting solely on yoga's relationship with inflammation. Its purpose was to synthesize current literature examining the impact of yoga interventions on inflammatory biomarkers in adults with chronic inflammatory-related disorders. METHOD Searches of several electronic databases were conducted. Inclusion criteria were (a) English language, (b) sample age >18 years old, (c) yoga interventions involving postures with or without yoga breathing and/or meditation, and (d) measured inflammatory biomarkers. RESULTS The final review included 15 primary studies. Of these, seven were rated as excellent and eight as average or fair. There was considerable variability in yoga types, components, frequency, session length, intervention duration, and intensity. The most common biomarkers measured were interleukin-6 ( n = 11), C-reactive protein ( n = 10), and tumor necrosis factor ( n = 8). Most studies reported positive effects on inflammatory biomarkers ( n = 11) from baseline to post yoga intervention. Analysis of the dose showed higher total dose (>1,000 min) resulted in greater improvements in inflammation. CONCLUSION This review suggests that yoga can be a viable intervention to reduce inflammation across a multitude of chronic conditions. Future studies with detailed descriptions of yoga interventions, measurement of new and well-established inflammatory biomarkers, and larger sample sizes are warranted to advance the science and corroborate results.
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Affiliation(s)
- Dilorom M Djalilova
- 1 Omaha Division, College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Paula S Schulz
- 2 Lincoln Division, College of Nursing, University of Nebraska Medical Center, Lincoln, NE, USA
| | - Ann M Berger
- 1 Omaha Division, College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Adam J Case
- 3 Department of Cellular and Integrative Physiology, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kevin A Kupzyk
- 1 Omaha Division, College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Alyson C Ross
- 4 Nursing Department, National Institutes of Health Clinical Center, Bethesda, MD, USA
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Haier J, Duda A, Branss-Tallen C. Improvement of well-being in cancer patients by yoga training. MEDICAL JOURNAL OF INDONESIA 2018. [DOI: 10.13181/mji.v27i3.2744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Background: Cancer patients frequently suffer from a reduced physical activity. Non-pharmacological interventions, such as yoga, provide opportunities to deal with these symptoms. The aim of this study is to evaluate the effect of yoga on the well-being of cancer patients.Methods: Between 2015 and 2017, we analyzed the effects of yoga on the well-being of cancer patients. Fifty-one patients received yoga training specifically designed to address cancer-related problems. Before the start (SoS) and after the end (EoS) of training, the WHO-5 well-being index was used to evaluate patients’ perception.Results: WHO-5 scores significantly improved from 47.1±21.4 at SoS to 69.7±15.1 at EoS. Patients in the middle age group (EoS–SoS: 28.0±20.6) showed a significantly higher benefit (p<0.005) compared with age groups <40 years (EoS–SoS: 10.7±15.4) and >60 years (EoS–SoS: 16.0±12.1). Patients with low initial scores benefited most from yoga.Conclusion: Our study showed that yoga training under experienced supervision could serve as a beneficial complementary treatment in cancer patients. Best effects were observed in patients with highly reduced well-being and 40–60-year-old patients.
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