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Petrigna L, Zanghì M, Maugeri G, D'Agata V, Musumeci G. Methodological consideration for a physical activity intervention in breast cancer population: An umbrella review. Heliyon 2023; 9:e17470. [PMID: 37455988 PMCID: PMC10338308 DOI: 10.1016/j.heliyon.2023.e17470] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Objective Breast cancer patients and survivors are increasing in the last years such as their mean age. A feasible and useful complementary intervention to improve physical and psychological health, and decrease some disease symptoms seems to be physical activity. Consequently, this umbrella review wanted to analyze the protocols of different physical activity interventions and to eventually propose a standard operating procedure for possible exercise training in breast cancer patients.Design, Data sources, Eligibility criteria. The electronic databases PubMed, Scopus, and Web of Science were searched till 25 March 2022 to detect all systematic review and meta-analysis of randomized controlled trials on this topic. The studies were analyzed narratively and evaluated with a scale to assess their quality. Results The studies presented heterogeneity in their population included in terms of disease stage and treatments, intervention protocols and outcomes evaluated. This made difficult to synthesize the findings. Conclusion It was not possible to propose a standard operating procedure but some indications were proposed to provide feedback for future studies. Ideally, an intervention should be composed of combined training (aerobic and resistance training) with a component of a mindfulness intervention, with an intensity from moderate to high, and 3 times a week. The intervention should be supervised in the first period and then it could be home-based. Exercise training should be personalized to the patients treated.
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Affiliation(s)
- Luca Petrigna
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Marta Zanghì
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Grazia Maugeri
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Velia D'Agata
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
- Department of Biology, College of Science and Technology, Sbarro Health Research Organization, Temple University, Philadelphia, PA, 19122, USA
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Chang CI, Yeh ML, Liao J. Chan-Chuang qigong with breathing meditation improves quality of life and interoceptive awareness in patients with breast cancer: a randomised controlled trial. Support Care Cancer 2023; 31:140. [PMID: 36707489 DOI: 10.1007/s00520-023-07578-w] [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: 06/28/2022] [Accepted: 01/05/2023] [Indexed: 01/29/2023]
Abstract
PURPOSE To evaluate the effect of Chan-Chuang qigong with breathing meditation on quality of life (QoL) and interoceptive awareness in patients with breast cancer during chemotherapy. METHODS This was a randomised controlled trial. Participants were randomly assigned to a qigong group (n = 30), which practised Chan-Chuang qigong with breathing meditation for 15 weeks, and a control group (n = 30), which received routine care. Outcomes were measured by using the European Organization for Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ-C30) and Multidimensional Assessment of Interoceptive Awareness (MAIA-C). RESULTS The qigong group, when compared with the control group and baseline, exhibited significantly improved emotional function (p = 0.01) and decreased role function (p = 0.04) at week 15. The MAIA-C indicated a significant difference between groups in self-regulation at week 15 (p = 0.04). Within the qigong group, changes were found in attention regulation (p = 0.03), emotional awareness (p = 0.04), self-regulation (p = 0.01), and body listening (p = 0.002). CONCLUSIONS A 15-week programme of Chan-Chuang qigong with breathing meditation is a simple and safe intervention for patients with breast cancer to improve their emotional function and adjust to their role identity. Participants who practised qigong achieved increased awareness of their own bodies and were able to better regulate their emotion and attention. TRIAL REGISTER ClinicalTrials.gov Identifier: NCT05385146.
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Affiliation(s)
- Ching-I Chang
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Minte Road, Peitou District, Taipei City, 1112303, Taiwan.,Chang Gung University of Science and Technology, No.261, Wenhua 1st Rd., Guishan Dist, Taoyuan City, 333324, Taiwan
| | - Mei-Ling Yeh
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Minte Road, Peitou District, Taipei City, 1112303, Taiwan.
| | - Justin Liao
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Minte Road, Peitou District, Taipei City, 1112303, Taiwan
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Li W, You F, Wang Q, Shen Y, Wang J, Guo J. Effects of Tai Chi Chuan training on the QoL and psychological well-being in female patients with breast cancer: a systematic review of randomized controlled trials. Front Oncol 2023; 13:1143674. [PMID: 37197428 PMCID: PMC10183581 DOI: 10.3389/fonc.2023.1143674] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
Background Tai Chi Chuan (TCC) may have a positive impact on physical and psychological well-being in breast cancer patients, but the evidence remains limited and inconclusive. This systematic review aims to evaluate the effects of TCC on the quality of life (QoL) and psychological symptoms in women patients with breast cancer. Methods This review has been registered on PROSPERO (ID: CRD42019141977). Randomized controlled trials (RCTs) of TCC for breast cancer were searched from eight major English and Chinese databases. All trials included were analyzed in accordance with the Cochrane Handbook. The primary outcomes were QoL, anxiety, and depression in patients with breast cancer. Fatigue, sleep quality, cognitive function, and inflammatory cytokine were the secondary outcomes. Results Fifteen RCTs involving a total of 1,156 breast cancer participants were included in this review. The methodological quality of included trials was generally poor. The pooled results suggested that TCC-based exercise could significantly improve QoL [standardized mean difference (SMD)=0.35, 95%CI: 0.15-0.55, I 2 = 0, model: fixed, IV], anxiety [weighted mean difference (WMD)=-4.25, 95%CI: -5.88 to -2.63, I 2 = 0, model: fixed, IV], and fatigue (SMD=-0.87, 95%CI: -1.50 to -0.24, I 2 = 80.9%, model: random, DL) compared other controls, with moderate to low certainty of evidence. The improvement of QoL and fatigue by TCC was also clinically meaningful. However, TCC-based exercise failed to show any between-group differences in depression, sleep quality, cognitive function, and inflammatory cytokine. Post-hoc analysis revealed that TCC-based exercise outperformed the other exercise in improving shoulder function with very low certainty of evidence. Conclusion Our findings manifested that TCC-based exercise is helpful for improving the QoL, anxiety, and fatigue in patients with breast cancer within the range of comparisons covered in this study. However, the results must be treated with great caution because of the methodological flaws of included trials. Larger, well-designed, and conducted randomized controlled trials with longer follow-up is warranted in the future to evaluate the important outcomes of TCC for breast cancer. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141977, identifier, CRD42019141977.
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Affiliation(s)
- Wenyuan Li
- Evidence Based Traditional Chinese Medicine Center of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Traditional Chinese Medicine Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fengming You
- Traditional Chinese Medicine Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Teaching and Research Office of Oncology in Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Departmental Office of Scientific Research, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qiaoling Wang
- Departmental Office of Scientific Research, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yifeng Shen
- Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jundong Wang
- Evidence Based Traditional Chinese Medicine Center of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Traditional Chinese Medicine Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Guo
- Teaching and Research Office of Oncology in Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Jing Guo,
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Zanghì M, Petrigna L, Maugeri G, D’Agata V, Musumeci G. The Practice of Physical Activity on Psychological, Mental, Physical, and Social Wellbeing for Breast-Cancer Survivors: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10391. [PMID: 36012025 PMCID: PMC9407710 DOI: 10.3390/ijerph191610391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
(1) Background: The number of breast-cancer patients and survivors is increasing in the last years. Physical activity seems to be a feasible and useful complementary intervention to improve the physical, psychological, and social spheres and decrease some symptoms, especially for survivors. Consequently, the objective of the present umbrella review was to analyze the efficacy of different physical-activity interventions in the physical, mental, and social spheres of breast-cancer survivors. (2) Methods: Systematic reviews and meta-analyses of randomized controlled trials on breast-cancer survivors and physical-activity effects were searched on the electronic databases PubMed, Web of Science, and Scopus till 9 August 2022. The quality of the studies included was evaluated, and the results were narratively analyzed. (3) Results: Physical-activity intervention generally improves the physical, mental, and social spheres of breast-cancer survivors, but the studies included present heterogeneity in the protocols adopted. (4) Conclusions: A well-structured and planned physical-activity intervention is useful for improvements in the physical, mental, and social spheres of breast-cancer survivors, but the studies presented high heterogeneity. Yoga seems to be the most effective physical intervention to complement medical therapy.
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Affiliation(s)
- Marta Zanghì
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Science Section, School of Medicine, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy
| | - Luca Petrigna
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Science Section, School of Medicine, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy
| | - Grazia Maugeri
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Science Section, School of Medicine, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy
| | - Velia D’Agata
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Science Section, School of Medicine, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Science Section, School of Medicine, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123 Catania, Italy
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5
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Xu J, Li H, Sze DMY, Chan VWS, Yang AWH. Effectiveness of qigong and tai chi in the quality of life of patients with cancer: protocol for an umbrella review. BMJ Open 2022; 12:e057980. [PMID: 35365537 PMCID: PMC8977801 DOI: 10.1136/bmjopen-2021-057980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Qigong and tai chi (QTC) have been adopted by many patients with cancer as a complementary treatment with their conventional mainstream cancer management. Findings from current systematic reviews are inconsistent. Some research indicated that either qigong or tai chi interventions could enhance quality of life (QoL), and improve cancer-related symptoms such as fatigue, sleep disturbance and anxiety; while others argued that there was a lack of efficacy of QTC on QoL improvement. This umbrella review will analyse and synthesise the findings from published systematic reviews and meta-analyses regarding the effectiveness of QTC in the QoL of patients with cancer. Twenty-five databases will be searched from their respective inception to December 2021. METHODS AND ANALYSIS We will conduct a search in 21 English and 4 Chinese databases to identify qualified systematic reviews and meta-analyses. Two reviewers will independently screen all the titles and abstracts, and determine whether the article meets the inclusion criteria. After the identified systematic reviews and/or meta-analyses are confirmed, important information from each article will be extracted to the characteristics table by two reviewers independently. Two reviewers will independently analyse the quality of the selected reviews based on the Assessment of Multiple Systematic Reviews guideline. Findings from the systematic reviews and/or meta-analyses will be summarised and reported. ETHICS AND DISSEMINATION This review does not require ethics approval as the study is based on the published articles. The results drawn from the present review will be submitted to peer-reviewed journals for publication or presented at conferences. PROSPERO REGISTRATION NUMBER CRD42021253216.
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Affiliation(s)
- Jing Xu
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Hong Li
- Syndrome Laboratory of Integrated Chinese and Western Medicine, School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
- School of Science, RMIT University, Melbourne, Victoria, Australia
| | - Daniel Man-Yuen Sze
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Vincent Wan Shing Chan
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Angela Wei Hong Yang
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
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6
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Lee SH, Jeon Y, Huang CW, Cheon C, Ko SG. Qigong and Tai Chi on Human Health: An Overview of Systematic Reviews. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2022; 50:1995-2010. [DOI: 10.1142/s0192415x22500859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Qigong and Tai chi are traditional methods of physical and mental training and exercises in East Asia. Their health-promoting effects against various diseases have been studied for a long time, and they have been the subject of many clinical trials and systematic reviews (SRs). The present study aimed to comprehensively evaluate all published SRs on Qigong and Tai chi and to summarize the supporting evidence. The following databases were searched: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Research Information Sharing Service, and Korean Studies Information Service System. The selection and extraction processes were performed by two independent reviewers, and a qualitative synthesis was conducted. There were 58 SRs of randomized controlled trials on Qigong and Tai chi. There have been many studies on patients with cardiovascular diseases and different cancers, and a number of other studies in which mobility, quality of life, blood lipids, and blood pressure were outcome measurements. Thus, Qigong and Tai chi for various diseases and medical conditions have been accumulated. Based on current evidence, the number of publications of Qigong and Tai chi-related articles showed an increasing trend, and most of them were performed in China. Qigong and Tai chi have shown beneficial effects in different age groups and health conditions, including decreasing blood lipid level, reducing blood pressure, facilitating mobility, preventing falls, and improving overall quality of life.
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Affiliation(s)
- Su Hyeon Lee
- College of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Yerim Jeon
- College of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ching-Wen Huang
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Chunhoo Cheon
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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7
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Gholamalishahi S, Okechukwu C, La Torre G, Mannocci A. Effects of Tai Chi and Qigong on fatigue and quality of life in patients with breast cancer: A narrative review of systematic reviews and meta-analyses. CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_194_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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8
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Durosini I, Triberti S, Sebri V, Giudice AV, Guiddi P, Pravettoni G. Psychological Benefits of a Sport-Based Program for Female Cancer Survivors: The Role of Social Connections. Front Psychol 2021; 12:751077. [PMID: 34899491 PMCID: PMC8664561 DOI: 10.3389/fpsyg.2021.751077] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
In the context of sports-based interventions for improving health and quality of life in chronic patients, participants could develop meaningful social relationships that affect their well-being as much as intervention activities. In this study, 80 female cancer survivors participated in a running-based group intervention (2 sessions/week; 1.5 h), while 51 acted as controls. The intervention lasted approximately 5 months. Unfortunately, the length of the intervention was reduced and sport activities were altered by the COVID-19 pandemic and lockdown mid-intervention, while the shared therapy sessions continued online. This possibly altered the results, as anxiety, depression, and physical aspects did not show significant differences between the experimental and control groups after the intervention. Participants reported positive comments on the experience as a whole, especially regarding the positive influence of the newly developed social connections. This was corroborated by significant correlations between group perceived cohesion and anxiety, depression, self-efficacy, and positive experience with the group psychological support. Overall, it is possible to suggest that in the program an important role was played by social connections and support, peer influence and the group experience, preserving positive experiential qualities of the intervention even if it was altered by external circumstances.
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Affiliation(s)
- Ilaria Durosini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Stefano Triberti
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Valeria Sebri
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Alice Viola Giudice
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Paolo Guiddi
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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9
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Yang L, Winters-Stone K, Rana B, Cao C, Carlson LE, Courneya KS, Friedenreich CM, Schmitz KH. Tai Chi for cancer survivors: A systematic review toward consensus-based guidelines. Cancer Med 2021; 10:7447-7456. [PMID: 34533284 PMCID: PMC8559497 DOI: 10.1002/cam4.4273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 12/21/2022] Open
Abstract
To manage acute, long‐term, and late effects of cancer, current guidelines recommend moderate‐to‐vigorous intensity aerobic and resistance exercise. Unfortunately, not all cancer survivors are able or willing to perform higher intensity exercise during difficult cancer treatments or because of other existing health conditions. Tai Chi is an equipment‐free, multicomponent mind–body exercise performed at light‐to‐moderate intensity that may provide a more feasible alternative to traditional exercise programs for some cancer survivors. This systematic review evaluated the therapeutic efficacy of Tai Chi across the cancer care continuum. We searched MEDLINE/PubMed, Embase, SCOPUS, and CINAHL databases for interventional studies from inception to 18 September 2020. Controlled trials of the effects of Tai Chi training on patient‐reported and objectively measured outcomes in cancer survivors were included. Study quality was determined by the RoB 2 tool, and effect estimates were evaluated using the Best Evidence Synthesis approach. Twenty‐six reports from 14 trials (one non‐randomized controlled trial) conducted during (n = 5) and after treatment (after surgery: n = 2; after other treatments: n = 7) were included. Low‐level evidence emerged to support the benefits of 40–60 min of thrice‐weekly supervised Tai Chi for 8–12 weeks to improve fatigue and sleep quality in cancer survivors. These findings need to be confirmed in larger trials and tested for scaling‐up potential. Insufficient evidence was available to evaluate the effects of Tai Chi on other cancer‐related outcomes. Future research should examine whether Tai Chi training can improve a broader range of cancer outcomes including during the pre‐treatment and end of life phases.
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Affiliation(s)
- Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada.,Departments of Oncology, University of Calgary, Calgary, Canada.,Departments of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Kerri Winters-Stone
- School of Nursing and Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Benny Rana
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada
| | - Chao Cao
- Program in Physical Therapy, Washington University School of Medicine, St Louis, Missouri, USA
| | - Linda E Carlson
- Departments of Oncology, University of Calgary, Calgary, Canada.,Department of Psychosocial Oncology, Alberta Health Services, Calgary, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada.,Departments of Oncology, University of Calgary, Calgary, Canada.,Departments of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Kathryn H Schmitz
- Penn State Cancer Institute, Penn State College of Medicine, Hershey, Pennsylvania, USA
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10
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Huang J, Liu H, Chen J, Cai X, Huang Y. The Effectiveness of Tai Chi in Patients With Breast Cancer: An Overview of Systematic Reviews and Meta-Analyses. J Pain Symptom Manage 2021; 61:1052-1059. [PMID: 33068706 DOI: 10.1016/j.jpainsymman.2020.10.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND As a mind-body exercise, Tai Chi (TC) may have a positive impact on physical function and psychological well-being in patients with breast cancer (BC). The aim of this current overview of systematic reviews (SRs) and meta-analyses (MAs) was to identify and summarize the existing evidence regarding the effectiveness of TC in patients with BC. METHODS A computerized search of electronic databases was performed to identify relevant SRs/MAs of TC related to BC from inception to June 2020. The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklists were used to assess the methodological quality and reporting quality of SRs and MAs, respectively. The Grades of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to assess the evidence quality of outcome measures. RESULTS Six SRs/MAs in which quantitative synthesis was used to assess various outcomes of TC related to BC were included in this overview. The quality of the SRs/MAs and the evidence quality of the outcome measures were generally unsatisfactory. The limitations of the past SRs/MAs were the lack of a protocol and registration, a list of excluded studies, or inadequately reported computational details of meta-analyses. The critical problems were that the qualitative data synthesis relied on the trials with small sample sizes and of critical low quality. CONCLUSIONS TC is possibly beneficial to BC treatment. However, further rigorous and comprehensive studies are required to provide robust evidence for definitive conclusions.
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Affiliation(s)
- Jinke Huang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haolin Liu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiajie Chen
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaowen Cai
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Yong Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.
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11
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Cui B, Peng F, Lu J, He B, Su Q, Luo H, Deng Z, Jiang T, Su K, Huang Y, Ud Din Z, Lam EWF, Kelley KW, Liu Q. Cancer and stress: NextGen strategies. Brain Behav Immun 2021; 93:368-383. [PMID: 33160090 DOI: 10.1016/j.bbi.2020.11.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/17/2020] [Accepted: 11/01/2020] [Indexed: 12/12/2022] Open
Abstract
Chronic stress is well-known to cause physiological distress that leads to body balance perturbations by altering signaling pathways in the neuroendocrine and sympathetic nervous systems. This increases allostatic load, which is the cost of physiological fluctuations that are required to cope with psychological challenges as well as changes in the physical environment. Recent studies have enriched our knowledge about the role of chronic stress in disease development, especially carcinogenesis. Stress stimulates the hypothalamic-pituitaryadrenal (HPA) axis and the sympathetic nervous system (SNS), resulting in an abnormal release of hormones. These activate signaling pathways that elevate expression of downstream oncogenes. This occurs by activation of specific receptors that promote numerous cancer biological processes, including proliferation, genomic instability, angiogenesis, metastasis, immune evasion and metabolic disorders. Moreover, accumulating evidence has revealed that β-adrenergic receptor (ADRB) antagonists and downstream target inhibitors exhibit remarkable anti-tumor effects. Psychosomatic behavioral interventions (PBI) and traditional Chinese medicine (TCM) also effectively relieve the impact of stress in cancer patients. In this review, we discuss recent advances in the underlying mechanisms that are responsible for stress in promoting malignancies. Collectively, these data provide approaches for NextGen pharmacological therapies, PBI and TCM to reduce the burden of tumorigenesis.
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Affiliation(s)
- Bai Cui
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China; State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, 651 Dongfeng East Road, Guangzhou, Guangdong Province 510060, China
| | - Fei Peng
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Jinxin Lu
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Bin He
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Qitong Su
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Huandong Luo
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Ziqian Deng
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Tonghui Jiang
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Keyu Su
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Yanping Huang
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Zaheer Ud Din
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Eric W-F Lam
- Department of Surgery and Cancer, Imperial College London, London W12 0NN, UK
| | - Keith W Kelley
- Department of Pathology, College of Medicine and Department of Animal Sciences, College of ACES, University of Illinois at Urbana-Champaign, 212 Edward R. Madigan Laboratory, 1201 West Gregory Drive, Urbana, Il 61801, USA.
| | - Quentin Liu
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China; State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, 651 Dongfeng East Road, Guangzhou, Guangdong Province 510060, China.
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12
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Zhang Y, Yao F, Kuang X, Li L, Huang L, Zhou Q, Peng J, Chang Q. How Can Alternative Exercise Traditions Help Against the Background of the COVID-19 in Cancer Care? An Overview of Systematic Reviews. Cancer Manag Res 2020; 12:12927-12944. [PMID: 33363409 PMCID: PMC7753005 DOI: 10.2147/cmar.s282491] [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] [Received: 09/17/2020] [Accepted: 11/20/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose To evaluate the quality of systematic reviews/meta-analyses (SR/MAs) on alternative exercise traditions in cancer care. Methods PubMed, Cochrane Library, Web of Science, Ovid, EBSCOhost, WanFang Database, China National Knowledge Infrastructure, and VIP Database were searched from their inception to June 30, 2020. The search used a combination of subject words and free words. The search terms included “Tai Chi,” “Qigong,” “Baduanjin,” “Yoga,” “Pilates,” “Cancer,” “Meta-analysis,” and “Systematic review.” Two researchers independently performed literature screening and data extraction and used AMSTAR scale and PRISMA statement to evaluate the methodology and the quality of the evidence. Results A total of 26 SR/MAs were included. The AMSTAR scale score was 5–10 points, with an average of 7.46±1.33 points. Overall, the methodological quality was considered to be moderate. The PRISMA list score was 13–24 points, with an average of 19.19±2.86 points. Among the papers evaluated, eight reports were relatively complete. A total of 15 papers indicated certain defects. A total of three papers showed relatively serious information defects. Conclusion Relative to the control group, alternative exercise traditions may be effective in improving the quality of life, anxiety, depression, distress, and fatigue of cancer patients. However, they may not necessarily improve patients’ sleep outcome, body mass index, and pain. During convalescence, cancer patients can be encouraged to start engaging in physical exercise, and professionals can develop appropriate exercise alternatives to ensure the expected effect of exercise while ensuring the safety of patients. The methodological quality of the systematic evaluations of the intervention effects of alternative exercise traditions on cancer patients is not satisfactory. Hence, focus should be directed to the improvement of the preliminary design scheme, publication status, literature retrieval, conflict of interest, and other aspects.
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Affiliation(s)
- Yang Zhang
- Department of Nursing, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215600, People's Republic of China
| | - Fang Yao
- Department of Nursing, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215600, People's Republic of China
| | - Xiaohong Kuang
- Department of Nursing, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215600, People's Republic of China
| | - Lijuan Li
- Department of Nursing, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215600, People's Republic of China
| | - Lihua Huang
- Department of Nursing, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215600, People's Republic of China
| | - Qi Zhou
- Department of Nursing, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215600, People's Republic of China
| | - Jiazhu Peng
- Department of Nursing, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215600, People's Republic of China
| | - Qingyu Chang
- Department of Surgery, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215600, People's Republic of China
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13
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Mokhtari-Hessari P, Montazeri A. Health-related quality of life in breast cancer patients: review of reviews from 2008 to 2018. Health Qual Life Outcomes 2020; 18:338. [PMID: 33046106 PMCID: PMC7552560 DOI: 10.1186/s12955-020-01591-x] [Citation(s) in RCA: 154] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 10/01/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Breast cancer still is a topic. This overview of the literature aimed to update the current knowledge on quality of life in breast cancer patients. METHODS A review of literature in MEDLINE, Cochrane Database of Systematic Reviews and Google Scholar were carried out to identify review papers on health-related quality of life in breast cancer during the 2008 to 2018. All publications were screened using the PRISMA guideline. The methodological quality of reviews was assessed using the AMSTAR. The findings were summarized and tabulated accordingly. RESULTS Within over a decade, a total of 974 review papers were identified which according to the study selection criteria finally we have evaluated 82 reviews. Of these about 85% had a reasonable methodological quality. The findings were mainly summarized on several headings including instruments used to measure quality of life, treatment, supportive care, psychological distress, and symptoms. Questionnaires had a good performance to quantify quality of life in breast cancer patients. Most reviews were focused on the impact of treatment including endocrine therapy as well as integrating complementary and alternative medicine into the current practice. According to the reviews, yoga was the most recommended exercise to improve quality of life in breast cancer patients. CONCLUSION Overall, the findings from this overview indicated that quality of life in breast cancer patients enhanced during the last decade. Several simple but effective interventions such as physical activity and psychosocial interventions proved to be effective in improving quality of life in this population. However, management of symptoms such as pain, and lymphedema, issues related to worry, sexual function especially for young patients, and the future outlooks all are among topics that deserve further consideration. Also, this overview indicated that methodological issues in measuring quality of life in breast cancer patients improved greatly, but still there is a long way to go to understand what really matter to patients.
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Affiliation(s)
- Parisa Mokhtari-Hessari
- Integrative Oncology Research Group, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
- Faculty of Humanity Sciences, University of Science and Culture, ACECR, Tehran, Iran
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14
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Wang X, Xu L, Dai N, Yang X, He Q, Tan L, Wang R, Li F. The effect of Tai Chi practice on immunological function in cancer survivors: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e21869. [PMID: 32899017 PMCID: PMC7478452 DOI: 10.1097/md.0000000000021869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Tai Chi has been reported to be potentially effective for health and well-being of cancer survivors. It is worth to assess the effectiveness and safety of Tai Chi on immunological function in people with cancer. METHODS All relevant randomized controlled trials (RCT) will be reviewed on Tai Chi for immunological function in cancer survivors. Literature searching will be conducted until March 9, 2019 from major English and Chinese databases: Cochrane Library, Excerpta Medica Database (EMBASE), PubMed, CINAHL, Sprotdicus, American Association for Cancer Research Journals, Sino-Med database, China National Knowledge Infrastructure, Chinese Science and Technique Journals Database, and Wanfang Data Chinese database. Two authors will conduct data selection and extraction independently. Quality assessment will be conducted using the risk of bias tool recommended by the Cochrane Collaboration. We will conduct data analysis using Cochrane's RevMan software (V.5.3). Forest plots and summary of findings tables will illustrate the results from a meta-analysis if sufficient studies with the same outcomes are identified. Funnel plots will be developed to evaluate reporting bias. RESULTS This review will summarize the evidence on Tai Chi for immunological function in cancer survivors. CONCLUSIONS We hope that the results of this study will provide significant evidence to assess the value Tai Chi practice on immunological function in cancer survivors. ETHICS AND DISSEMINATION Ethics approval is not required as this study will not involve patients. The results of this study will be submitted to a peer-reviewed journal for publication.
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Affiliation(s)
| | - Lei Xu
- Beijing University of Chinese Medicine
- Department of Liver Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ning Dai
- Beijing University of Chinese Medicine
| | | | | | - Libo Tan
- Beijing University of Chinese Medicine
| | - Ruochong Wang
- Beijing University of Chinese Medicine
- Department of Liver Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Feng Li
- Beijing University of Chinese Medicine
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15
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Lee SM, Choi HC, Hyun MK. An Overview of Systematic Reviews: Complementary Therapies for Cancer Patients. Integr Cancer Ther 2020; 18:1534735419890029. [PMID: 31876212 PMCID: PMC6933541 DOI: 10.1177/1534735419890029] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Introduction: This article critically examines the systematic
reviews (SR) and meta-analysis (MA) of complementary therapies for cancer
patients to appraise the evidence level, and offers suggestions for future
research and practice. Methods: The Cochrane Library and MEDLINE
were searched from their inception to January 2018, to identify SR and MA of
complementary therapies available for cancer patients. Final selected SR and MA
were methodologically evaluated for their quality by applying the Assessing the
Methodological Quality of Systematic Reviews 2 (AMSTAR2) instrument. Data
extraction and risk of quality assessments were performed by 2 independent
reviewers. Results: A total of 104 studies were included in the
analysis. The majority of the individual clinical trials included in the SR and
MA were performed in China (48%) and the United States (26.9%). Breast cancer
was the most studied cancer type (25%), and acupuncture was the most studied
intervention (21%). Side effects of cancer such as pain, depression, and fatigue
were effectively managed with complementary therapies. The methodologically
problematic items included not listing the excluded studies and lack of protocol
or protocol registration. Conclusions: With increasing interest in
research, complementary therapies appear to be beneficial in reducing side
effects and raising the quality of life of cancer patients. Complementary
therapies have generally been studied for all cancers, with acupuncture being
the most researched, regardless of the cancer type. Since AMSTAR2 is a stricter
assessment tool than before, future studies need to consider the risk of
methodological bias with caution and discuss appropriate overall quality
assessment tools.
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Affiliation(s)
- Seong Min Lee
- College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Ho Cheol Choi
- College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Min Kyung Hyun
- Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea
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16
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Luo XC, Liu J, Fu J, Yin HY, Shen L, Liu ML, Lan L, Ying J, Qiao XL, Tang CZ, Tang Y. Effect of Tai Chi Chuan in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Front Oncol 2020; 10:607. [PMID: 32391277 PMCID: PMC7191057 DOI: 10.3389/fonc.2020.00607] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 04/02/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Tai Chi Chuan(TCC), as a mind-body exercise, may have a positive impact on physical function and psychological well-being in breast cancer patients. The latest systematic review and meta-analysis of TCC for breast cancer was made 4 years ago and some new clinical trials about it were published. We remade a systematic review and meta-analysis to evaluate the effect of TCC in breast cancer patients. Methods: In this systematic review and meta-analysis, we searched MEDLINE (via PubMed), EMBASE (via embase.com), CENTRAL, CNKI, COVIP, Wanfang, Chaoxing, CiNii, J-SSTAGE, DBpia, and ThaiJO with no language restrictions from inception to December 31, 2018 (updated on February 16, 2020), for randomized clinical trials comparing TCC with non-exercised therapy in breast cancer patients. The primary outcome was quality of life in patients with breast cancer and data pooled by a random-effects model. Subgroup analyses were conducted to estimate the effect of different durations of TCC for breast cancer patients. This study was registered in PROSPERO, number CRD 4201810326. Results: Fifteen articles involving a total of 885 breast cancer participants were included in this review. Compared with non-exercised therapy, TCC had a significant effect on quality of life in breast cancer patients (SMD = 0.37, 95% CI 0.15–0.59, p = 0.001), and subgroup analysis found that TCC showed beneficial effect in 12 weeks and 25 weeks (12 weeks: SMD = 0.40, 95% CI 0.19–0.62, p = 0.0003; 25 weeks: SMD = 0.38, 95% CI 0.15–0.62, p = 0.002). Meta-analyses of secondary outcomes showed that 3 weeks TCC increased shoulder function (SMD = 1.08, 95% CI 0.28–1.87, p = 0.008), 12 weeks TCC improved pain (SMD = 0.30, 95% CI 0.08–0.51, p = 0.007), shoulder function (SMD = 1.34, 95% CI 0.43–2.25, p = 0.004), strength of arm (SMD = 0.44, 95% CI 0.20–0.68, p = 0.0004), and anxiety (MD = −4.90, 95% CI −7.83 to −1.98, p = 0.001) in breast cancer patients compared with the control group. Conclusions: TCC appears to be effective on some physical and psychological symptoms and improves the quality of life in patients with breast cancer. Additional randomized controlled trials with a rigorous methodology and low risk of bias are needed to provide more reliable evidence.
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Affiliation(s)
- Xiao-Chao Luo
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jie Liu
- Sichuan Provincial People's Hospital, Chengdu, China
| | - Jia Fu
- Medical & Nursing School, Chengdu University, Chengdu, China
| | - Hai-Yan Yin
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Li Shen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Mai-Lan Liu
- The School of Acupuncture, Moxibustion & Tuina, Hunan University of Traditional Chinese Medicine, Changsha, China
| | - Lei Lan
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Key Laboratory of Sichuan Province for Acupuncture & Chronobiology, Chengdu, China
| | - Jian Ying
- Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Xiu-Lan Qiao
- Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Chun-Zhi Tang
- School of Acupuncture & Rehabilitation Medicine, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Yong Tang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Medical & Nursing School, Chengdu University, Chengdu, China.,Key Laboratory of Sichuan Province for Acupuncture & Chronobiology, Chengdu, China
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17
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Guo J, Shen Y, Li B, Wang F, Jiang Y, Lin Y, Chen J. Does Tai Chi Chuan improve psychological well-being and quality of life in patients with breast cancer? Protocol for a systematic review of randomized controlled trials: A Protocol for Systematic Review and Meta-Analysis. Medicine (Baltimore) 2020; 99:e19681. [PMID: 32311942 PMCID: PMC7220518 DOI: 10.1097/md.0000000000019681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Breast cancer is the most prevalent cancer in women worldwide. Treatment for breast cancer can be expensive, painful and can significantly affect the quality of life, leading to various side effects such as depression and anxiety, fatigue, sleep disorders, and cognitive impairment. Tai Chi Chuan (TCC) is the most prominent manifestation of tai chi in Chinese martial arts. TCC has been reported to be potentially effective for health and well-being of both the sick and the healthy. However, it is still controversial whether TCC benefits breast cancer patients. It is therefore of great value to evaluate the effectiveness of TCC on the psychological well-being and quality of life in people with breast cancer. METHODS This review will summarize and meta-analyze all relevant randomized controlled trials on TCC in patients with breast cancer in the light of their anxiety, depression and fatigue level, inflammatory cytokine as well as quality of life, sleep quality, and cognitive function. The following electronic databases will be searched: PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, VIP Chinese Science and Technology Periodical Database, and Wan Fang Data. The methodologic quality of randomized controlled trials has been assessed using the Cochrane risk assessment tool. All trials included are analyzed according to the criteria of the Cochrane Handbook. Review Manager 5.3, R-3.5.1 software and grading of recommendations assessment, development, and evaluation pro-GDT online software are used for data synthesis and analysis. RESULTS The results of this systematic review will be used to summarize and evaluate the evidence available from randomized controlled clinical trials of TCC as supportive and adjuvant therapy for breast cancer. CONCLUSION This review will provide a detailed summary of the evidence to assess the effectiveness of TCC for breast cancer. OSF REGISTRATION DOI 10.17605/OSF.IO/Z2FSA.
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Affiliation(s)
- Jing Guo
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- School of Chinese Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Yifeng Shen
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Bin Li
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Fei Wang
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yang Jiang
- School of Chinese Medicine, University of Hong Kong, Pokfulam, Hong Kong
- Beijing Jishuitan Hospital, Xicheng District
| | - Yi Lin
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Jianping Chen
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- School of Chinese Medicine, University of Hong Kong, Pokfulam, Hong Kong
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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18
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Easwaran K, Gopalasingam Y, Green DD, Lach V, Melnyk JA, Wan C, Bartlett DJ. Effectiveness of Tai Chi for health promotion for adults with health conditions: a scoping review of Meta-analyses. Disabil Rehabil 2020; 43:2978-2989. [PMID: 32070137 DOI: 10.1080/09638288.2020.1725916] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose: To complete a scoping review of meta-analyses summarizing evidence of the effectiveness of Tai Chi for adults with health conditions.Materials and Methods: Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health and the Cochrane Library from database inception to early September 2018. Multistage deduplication and screening processes identified full-length, unique, peer-reviewed meta-analyses. Two people independently appraised 42 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables.Results: "High" and "moderate" quality evidence indicates that Tai Chi can significantly benefit adults with health conditions including cancers, chronic obstructive pulmonary disease, coronary heart disease, depression, heart failure, hypertension, low back pain, osteoarthritis, osteoporosis, Parkinson's Disease and stroke. Outcomes included significant improvements in activities of daily living, balance, exercise capacity, gait, mastery, mental health, mobility, motor function, participation in daily life, physical function, quality of life, range of motion, and strength; with reductions in blood pressure, body mass index, depression, disability, dyspnea, falls, fatigue, pain, stiffness, and waist circumference.Conclusions: Healthcare providers now have information to advise clients with health conditions on the effectiveness of Tai Chi for overall health promotion.IMPLICATIONS FOR REHABILITATIONTai Chi is a form of safe, enjoyable, light-to-moderate aerobic physical activity for adults that is inexpensive to implement in diverse community settings.Adults with health conditions require physical activity for prevention of secondary impairments and over-all health promotion.This scoping review of meta-analyses elucidates "high" and "moderate" quality evidence of the effectiveness of Tai Chi in improving important outcomes for people with numerous health conditions.This information can be useful for healthcare providers who wish to recommend effective community-based physical activity to clients they are serving.
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Affiliation(s)
- Kobena Easwaran
- Physical Therapy, Elborn College, Western University, London, Canada
| | | | - Danielle D Green
- Physical Therapy, Elborn College, Western University, London, Canada
| | - Veronica Lach
- Physical Therapy, Elborn College, Western University, London, Canada
| | - Jordan A Melnyk
- Physical Therapy, Elborn College, Western University, London, Canada
| | - Christina Wan
- Physical Therapy, Elborn College, Western University, London, Canada
| | - Doreen J Bartlett
- Physical Therapy, Elborn College, Western University, London, Canada
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19
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The effectiveness of tai chi in breast cancer patients: A systematic review and meta-analysis. Complement Ther Clin Pract 2020; 38:101078. [DOI: 10.1016/j.ctcp.2019.101078] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 12/08/2019] [Accepted: 12/09/2019] [Indexed: 12/24/2022]
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20
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Sasaki Y, Cheon C, Motoo Y, Jang S, Park S, Ko SG, Jang BH, Hwang DS. Complementary and Alternative Medicine for Breast Cancer Patients: An Overview of Systematic Reviews. YAKUGAKU ZASSHI 2019; 139:1027-1046. [DOI: 10.1248/yakushi.18-00215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Yui Sasaki
- Department of Applied Korean Medicine, Graduate School, Kyung Hee University
| | - Chunhoo Cheon
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University
| | | | - Soobin Jang
- Clinical Medicine Division, Korea Institute of Oriental Medicine
| | - Sunju Park
- Department of Preventive Medicine, College of Korean Medicine, Daejeon University
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University
| | - Bo-Hyoung Jang
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University
| | - Deok-Sang Hwang
- Department of Korean Gynecology, College of Korean Medicine, Kyung Hee University
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21
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The effects of Tai Chi on quality of life of cancer survivors: a systematic review and meta-analysis. Support Care Cancer 2019; 27:3701-3716. [DOI: 10.1007/s00520-019-04911-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
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22
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Olsson Möller U, Beck I, Rydén L, Malmström M. A comprehensive approach to rehabilitation interventions following breast cancer treatment - a systematic review of systematic reviews. BMC Cancer 2019; 19:472. [PMID: 31109309 PMCID: PMC6528312 DOI: 10.1186/s12885-019-5648-7] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 04/26/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Breast cancer (BC) is the most common type of cancer in women worldwide. Post-treatment, patients suffer from side effects and have various rehabilitation needs, which means that individualization is fundamental for optimal rehabilitation. This systematic review (SR) of SRs aims to evaluate the current evidence on rehabilitation interventions in female patients following BC treatment. METHODS Full-text SRs published in English from 2009 were searched in Embase, PubMed, Cinahl Complete, PsycINFO, AMED, SCOPUS, and Cochrane Library. INCLUSION CRITERIA SRs of randomized or non-randomized controlled trials investigating the effects of rehabilitation interventions in women following BC treatment. All outcomes were considered. Methodological quality was evaluated using the AMSTAR 2 tool and interrater agreement was evaluated. Out of 1269 citations retrieved, 37 SRs were included. RESULTS Five rehabilitation areas were identified: exercise and physical activity (PA), complementary and alternative medicine (CAM), yoga, lymphoedema treatment, and psychosocial interventions. The most solid evidence was found in exercise/PA and yoga. Exercise interventions improved outcomes such as shoulder mobility, lymphoedema, pain, fatigue and quality of life (QoL). Effects of yoga were shown on QoL, anxiety, depression, sleep disturbance, fatigue and gastrointestinal symptoms. The effect of CAM was shown on nausea, pain, fatigue, anger and anxiety but these results need to be interpreted with caution because of low methodological quality in included studies in the SRs. Among the lymphoedema treatments, positive effects were seen for resistance training on volume reduction and muscle strength and psychosocial interventions such as cognitive behavioural therapy had positive effects on QoL, anxiety, depression and mood disturbance. CONCLUSIONS This SR of SRs show solid positive effects of exercise/PA and yoga for women following BC treatment, and provides extended knowledge of the effects of CAM, yoga, lymphoedema treatment and psychosocial interventions. It is evident that more than one intervention could have positive effects on a specific symptom and that the effects depend not only on intervention type but also on how and when the intervention is provided. The results can be used as a foundation for individualized rehabilitation and aid health care professionals in meeting patients' individual needs and preferences. TRIAL REGISTRATION PROSPERO ( CRD42017060912 ).
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Affiliation(s)
- U Olsson Möller
- Department of Nursing and Integrated Health Sciences, Faculty of Medicine, Kristianstad University, Kristianstad, Sweden
| | - I Beck
- Department of Nursing and Integrated Health Sciences, Faculty of Medicine, Kristianstad University, Kristianstad, Sweden.,The Institute for Palliative Care, Lund University and Region Skåne, Lund, Sweden.,Department of Clinical Sciences in Lund, Oncology and Pathology, Lund University, Lund, Sweden
| | - L Rydén
- Department of Clinical Sciences Lund, Surgery, Lund University, Skåne University Hospital, Medicon Village 406, 223 81, Lund, Sweden.
| | - M Malmström
- The Institute for Palliative Care, Lund University and Region Skåne, Lund, Sweden.,Department of Health Sciences, Lund University, Lund, Sweden
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23
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Liao SJ, Chong MC, Tan MP, Chua YP. Tai Chi with music improves quality of life among community-dwelling older persons with mild to moderate depressive symptoms: A cluster randomized controlled trial. Geriatr Nurs 2018; 40:154-159. [PMID: 30173939 DOI: 10.1016/j.gerinurse.2018.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 08/09/2018] [Accepted: 08/10/2018] [Indexed: 10/28/2022]
Abstract
Depression leads to a poorer quality of life (QOL) which is a determinant of healthy ageing. Cost-effective solutions for enhancing QOL in the older population are much needed in China, with its rapidly ageing population. We conducted a randomized controlled trial involving 112 community-dwelling older participants with mild to moderate depression, to evaluate the effect of Tai Chi with music on QOL (57 in intervention group, 55 in control group). WHO Quality of Life-BREF was used to measure QOL at baseline and at every month for three months. Following the adjustments for sociodemographic data, the effect of intervention on QOL was assured (F = 25.145, P < 0.001, ηp2= 0.435, F = 18.696, P < 0.001, ηp2= 0.364, F = 17.473, P< 0.001, ηp2= 0.348, and F = 29.576, P < 0.001, ηp2= 0.475 for physical, psychological, social, and environment domains respectively). This intervention represents an economically viable solution to better QOL and healthy ageing in a highly populous developing nation.
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Affiliation(s)
- S J Liao
- Department of Nursing Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Ya'an Polytechnic College, 130 Yucai Road, Yucheng District, Ya'an City, Sichuan Province, China
| | - M C Chong
- Department of Nursing Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - M P Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Ageing and Age-Associated Disorders Research Group, Wellness Research Cluster, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y P Chua
- Institute of Educational Leadership, Faculty of Education, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Rudolph I, Schmidt T, Wozniak T, Kubin T, Ruetters D, Huebner J. Ballroom dancing as physical activity for patients with cancer: a systematic review and report of a pilot project. J Cancer Res Clin Oncol 2018; 144:759-770. [PMID: 29423728 DOI: 10.1007/s00432-018-2606-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 02/04/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Physical activity has positive effects on cancer patients. Dancing addresses diverse bio-psycho-social aspects. Our aim was to assess the evidence on ballroom dancing and to develop the setting for a pilot project. METHODS We performed a systematic review, extracted the data and designed a pilot training based on standard curricula. We included cancer patients during or after therapy. Training duration was 90 min with one regular pause and individual pauses as needed. RESULTS We retrieved two systematic reviews and six controlled studies. Types of dancing varied. Only one study used ballroom dancing. Dance training might improve well-being, physical fitness, fatigue and coping during and after therapy. Yet, evidence is scarce and data to derive the effect size are lacking; 27 patients and their partners took part in the pilot training. Patients and partners needed more time to learn the steps than is planned in regular ballroom classes. Participants were very satisfied with the adaptation of the training to their physical strength and estimated the training in a sheltered group. No side effects occurred. In spite of a high rate of participants reporting fatigue, 90 min of physical activity with only a few minutes of rest were manageable for all participants. CONCLUSION Ballroom dancing may offer benefits for patients with respect to quality of life. Cancer patients prefer sheltered training setting and curricula of regular ballroom classes must be adapted for cancer patients. Strict curricula might reduce motivation and adherence and exclude patients with lower or variable fitness.
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Affiliation(s)
- Ivonne Rudolph
- Deutsche Krebsgesellschaft, Kuno-Fischer-Str. 8, 14057, Berlin, Germany
| | - Thorsten Schmidt
- Krebszentrum Nord, CCC, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus 14, 24105, Kiel, Germany
| | - Tobias Wozniak
- Arbeitsgemeinschaft Prävention und Integrative Onkologie, Deutsche Krebsgesellschaft, Kuno-Fischer-Str. 8, 14057, Berlin, Germany
| | - Thomas Kubin
- Abt. für Hämatologie, Onkologie und Palliativmedizin, Kliniken Südostbayern AG, Klinikum Traunstein, Cuno-Niggl-Str. 3, 83278, Traunstein, Germany
| | - Dana Ruetters
- Deutsche Krebsgesellschaft, Kuno-Fischer-Str. 8, 14057, Berlin, Germany
| | - Jutta Huebner
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
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Tai Chi and Qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis. J Cancer Surviv 2017; 12:256-267. [PMID: 29222705 DOI: 10.1007/s11764-017-0665-5] [Citation(s) in RCA: 127] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 11/29/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE This study aims to summarize and critically evaluate the effects of Tai Chi and Qigong (TCQ) mind-body exercises on symptoms and quality of life (QOL) in cancer survivors. METHODS A systematic search in four electronic databases targeted randomized and non-randomized clinical studies evaluating TCQ for fatigue, sleep difficulty, depression, pain, and QOL in cancer patients, published through August 2016. Meta-analysis was used to estimate effect sizes (ES, Hedges' g) and publication bias for randomized controlled trials (RCTs). Methodological bias in RCTs was assessed. RESULTS Our search identified 22 studies, including 15 RCTs that evaluated 1283 participants in total, 75% women. RCTs evaluated breast (n = 7), prostate (n = 2), lymphoma (n = 1), lung (n = 1), or combined (n = 4) cancers. RCT comparison groups included active intervention (n = 7), usual care (n = 5), or both (n = 3). Duration of TCQ training ranged from 3 to 12 weeks. Methodological bias was low in 12 studies and high in 3 studies. TCQ was associated with significant improvement in fatigue (ES = - 0.53, p < 0.001), sleep difficulty (ES = - 0.49, p = 0.018), depression (ES = - 0.27, p = 0.001), and overall QOL (ES = 0.33, p = 0.004); a statistically non-significant trend was observed for pain (ES = - 0.38, p = 0.136). Random effects models were used for meta-analysis based on Q test and I 2 criteria. Funnel plots suggest some degree of publication bias. Findings in non-randomized studies largely paralleled meta-analysis results. CONCLUSIONS Larger and methodologically sound trials with longer follow-up periods and appropriate comparison groups are needed before definitive conclusions can be drawn, and cancer- and symptom-specific recommendations can be made. IMPLICATIONS FOR CANCER SURVIVORS TCQ shows promise in addressing cancer-related symptoms and QOL in cancer survivors.
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Mobaraki H, Azami-Aghdash S, Sarabi Asiabar A, Rezapour A, Kafaei Mehr MH, Emamgolizadeh S. Cost-effectiveness of Eplerenone in treatment of cardiovascular diseases: a systematic review. Med J Islam Repub Iran 2017. [PMID: 28638811 PMCID: PMC5473015 DOI: 10.18869/mjiri.31.4] [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] [Indexed: 11/09/2022] Open
Abstract
Background: No clear evidence is available on the cost-effectiveness of eplerenone in treatment of cardiovascular diseases. Thus, the present study aimed at systematically reviewing studies that have investigated this issue.
Methods: This systematic review study was conducted in 2016. The required information were collected using key Mesh words from the following databases: Google scholar, PubMed, Science Direct, MagIran, SID, Scopus, and handsearching journals and the references of the selected articles. The quality of the selected articles was assessed by the Drummond's checklist.
Results: Nine articles were included from 296 articles found in the literature review. The selected studies have been conducted in 8 countries (The United States, Britain, Australia, Switzerland, France, Spain, the Netherlands, and Canada). In general, the costeffectiveness of eplerenone was investigated in 31 757 patients with cardiovascular diseases. The average of quality-adjusted life years (QALY) in studies with nonmodeling approach was equal to 0.0908 in Framingham approach, 0.0595 in Saskatchewan approach, and 0.1309 in Worcester approach. The overall average cost of treating cardiovascular diseases with eplerenone was equal to US$6694 in 1 year. Cost per additional (QALY) was estimated to be US$9478. Incremental cost-effectiveness ratio was high in the United States compared to European countries. The Average quality of articles was estimated to be 7.4 from 10.
Conclusions: Based on the results of the studies reviewed in the present study, it seems that eplerenone has acceptable costeffectiveness compared with current treatments, placebo, and similar drugs.
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Affiliation(s)
- Hossein Mobaraki
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saber Azami-Aghdash
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Sarabi Asiabar
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
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Subramani R, Lakshmanaswamy R. Complementary and Alternative Medicine and Breast Cancer. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2017; 151:231-274. [DOI: 10.1016/bs.pmbts.2017.07.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Klein PJ, Schneider R, Rhoads CJ. Qigong in cancer care: a systematic review and construct analysis of effective Qigong therapy. Support Care Cancer 2016; 24:3209-22. [PMID: 27044279 DOI: 10.1007/s00520-016-3201-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 03/28/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE This review (a) assesses the strength of evidence addressing Qigong therapy in supportive cancer care and (b) provides insights for definition of effective Qigong therapy in supportive cancer care. METHODS This mixed-methods study includes (a) a systematic review of randomized clinical trials (RCTs) following PRISMA guidelines and (b) a constant-comparative qualitative analysis of effective intervention protocols. RESULTS Eleven published randomized clinical trials were reviewed. A total of 831 individuals were studied. Geographic settings include the USA, Australia, China, Hong Kong, and Malaysia. Qigong therapy was found to have positive effects on the cancer-specific QOL, fatigue, immune function, and cortisol levels of individuals with cancer. Qigong therapy protocols varied supporting a plurality of styles. Qualitative analyses identified common programming constructs. Content constructs included exercise (gentle, integrated, repetitious, flowing, weight-bearing movements), breath regulation, mindfulness and meditation, energy cultivation including self-massage, and emphasis on relaxation. Logistic constructs included delivery by qualified instructors, home practice, and accommodation for impaired activity tolerance. CONCLUSIONS There is global interest and a growing body of research providing evidence of therapeutic effect of Qigong therapy in supportive cancer care. While Qigong therapy protocols vary in style, construct commonalities do exist. Knowledge of the common constructs among effective programs revealed in this research may be used to guide future research intervention protocol and community programming design and development.
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Affiliation(s)
- P J Klein
- S.U.N.Y. at Buffalo, Buffalo, NY, USA.
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Tao WW, Jiang H, Tao XM, Jiang P, Sha LY, Sun XC. Effects of Acupuncture, Tuina, Tai Chi, Qigong, and Traditional Chinese Medicine Five-Element Music Therapy on Symptom Management and Quality of Life for Cancer Patients: A Meta-Analysis. J Pain Symptom Manage 2016; 51:728-747. [PMID: 26880252 DOI: 10.1016/j.jpainsymman.2015.11.027] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 11/19/2015] [Accepted: 11/20/2015] [Indexed: 10/22/2022]
Abstract
CONTEXT Most cancer patients suffer from both the disease itself and symptoms induced by conventional treatment. Available literature on the clinical effects on cancer patients of acupuncture, Tuina, Tai Chi, Qigong, and Traditional Chinese Medicine Five-Element Music Therapy (TCM-FEMT) reports controversial results. OBJECTIVES The primary objective of this meta-analysis was to evaluate the effect of acupuncture, Tuina, Tai Chi, Qigong, and TCM-FEMT on various symptoms and quality of life (QOL) in patients with cancer; risk of bias for the selected trials also was assessed. METHODS Studies were identified by searching electronic databases (MEDLINE via both PubMed and Ovid, Cochrane Central, China National Knowledge Infrastructure, Chinese Scientific Journal Database, China Biology Medicine, and Wanfang Database). All randomized controlled trials (RCTs) using acupuncture, Tuina, Tai Chi, Qigong, or TCM-FEMT published before October 2, 2014, were selected, regardless of whether the article was published in Chinese or English. RESULTS We identified 67 RCTs (5465 patients) that met our inclusion criteria to perform this meta-analysis. Analysis results showed that a significant combined effect was observed for QOL change in patients with terminal cancer in favor of acupuncture and Tuina (Cohen's d: 0.21-4.55, P < 0.05), whereas Tai Chi and Qigong had no effect on QOL of breast cancer survivors (P > 0.05). The meta-analysis also demonstrated that acupuncture produced small-to-large effects on adverse symptoms including pain, fatigue, sleep disturbance, and some gastrointestinal discomfort; however, no significant effect was found on the frequency of hot flashes (Cohen's d = -0.02; 95% CI = -1.49 to 1.45; P = 0.97; I(2) = 36%) and mood distress (P > 0.05). Tuina relieved gastrointestinal discomfort. TCM-FEMT lowered depression level. Tai Chi improved vital capacity of breast cancer patients. High risk of bias was present in 74.63% of the selected RCTs. Major sources of risk of bias were lack of blinding, allocation concealment, and incomplete outcome data. CONCLUSION Taken together, although there are some clear limitations regarding the body of research reviewed in this study, a tentative conclusion can be reached that acupuncture, Tuina, Tai Chi, Qigong, or TCM-FEMT represent beneficial adjunctive therapies. Future study reporting in this field should be improved regarding both method and content of interventions and research methods.
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Affiliation(s)
- Wei-Wei Tao
- College of Nursing, Dalian Medical University, Dalian, People's Republic of China.
| | - Hua Jiang
- School of Nursing, Peking University, Beijing, People's Republic of China
| | - Xiao-Mei Tao
- Beijing Shijitan Hospital, Beijing, People's Republic of China
| | - Ping Jiang
- Graduate School, Dalian Medical University, Dalian, People's Republic of China.
| | - Li-Yan Sha
- College of Nursing, Dalian Medical University, Dalian, People's Republic of China
| | - Xian-Ce Sun
- College of Public Health, Dalian Medical University, Dalian, People's Republic of China
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Effects of non-sporting and sporting qigong on frailty and quality of life among breast cancer patients receiving chemotherapy. Eur J Oncol Nurs 2016; 21:257-65. [DOI: 10.1016/j.ejon.2015.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 09/16/2015] [Accepted: 10/30/2015] [Indexed: 11/18/2022]
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Knight A, Hwa YS, Hashim H. Complementary alternative medicine use amongst breast cancer patients in the Northern region of peninsular Malaysia. Asian Pac J Cancer Prev 2016; 16:3125-30. [PMID: 25921108 DOI: 10.7314/apjcp.2015.16.8.3125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is a common cancer affecting women in Malaysia and the use of complementary/ alternative medicine (CAM) has been associated with delays in getting treatment. The aim of the study was to explore the use of CAM and the influencing factors in the Northern region of Peninsular Malaysia. MATERIALS AND METHODS This was a cross-sectional descriptive study on a convenience sample of 100 Malaysian breast cancer survivors. FINDINGS The reported use of CAM among the breast cancer survivors was lower than in other studies but the types of CAM used had a similar pattern with nutrition supplements/vitamins being the most common. The factors that positively influenced the use of complimentary/traditional therapy were income and getting information from television or radio. Survivors with access to internet/blogs appear to have lower odds of using complimentary/traditional therapy compared to the respondents who reported no such access. CONCLUSIONS Information transmitted via television and radio appears to have a positive influence on CAM use by breast cancer patients compared to other information sources and it is important to ensure that such information is accurate and impartial.
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Affiliation(s)
- Aishah Knight
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia E-mail :
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Meditative qigong relieved symptom severity and interference among patients with breast carcinoma receiving chemotherapy. Eur J Integr Med 2015. [DOI: 10.1016/j.eujim.2015.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Han KT, Park EC, Kim SJ, Jang SI, Shin J, Kim CO, Choi JW, Lee SG. Factors affecting the quality of life of Korean cancer survivors who return to the workplace. Asian Pac J Cancer Prev 2015; 15:8783-8. [PMID: 25374207 DOI: 10.7314/apjcp.2014.15.20.8783] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the prevalence of cancer is increasing, it is no longer synonymous with death. The number of cancer survivors is estimated to be increasing due to development in medical treatments and social programs; cancer survivors are increasingly returning to work after long-term unemployment. Thus, we examined the quality of life (QOL) and the factors associated with return of cancer survivors to the workplace. MATERIALS AND METHODS This study was performed using the 2008 Community Health Survey administered by the Korea Centers for Disease Control and Prevention (N=548). We used Chi-square tests to compare demographic variables based on self-perceived health status, and analysis of variance (ANOVA) to compare QOL scores among groups. We also performed a mixed-model analysis of the relationship between QOL and factors at the workplaces of cancer survivors. RESULTS Based on the results of our study, the overall QOL of cancer survivors was associated with 'mutual respect', 'free emotional expression', occupation, and age. Moreover, different trends of QOL according to self-perceived health were identified on additional analysis. In the 'bad' self-perceived health group, QOL was significantly different according to income. The QOL of cancer survivors in the low-income group was lower than in the other groups. Conversely, the 'normal' group had a lower QOL caused by 'no mutual respect' and "no free emotional expression" in the workplace. The QOL in the 'good' group based on self-perceived health was higher in the younger age group. CONCLUSIONS There may be a significant relationship between QOL and workplace factors for cancer survivors, although further study is needed to investigate this relationship in detail. This may facilitate formulation of policy and efforts to prevent and manage the decline in the QOL of cancer survivors returning to work.
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Affiliation(s)
- Kyu-Tae Han
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea E-mail :
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Tai chi chuan exercise for patients with breast cancer: a systematic review and meta-analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:535237. [PMID: 25793000 PMCID: PMC4352428 DOI: 10.1155/2015/535237] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 12/21/2014] [Indexed: 11/23/2022]
Abstract
Objective. Tai Chi Chuan (TCC) is a form of aerobic exercise that may be an effective therapy for improving psychosomatic capacity among breast cancer survivors. This meta-analysis analyzed the available randomized controlled trials (RCTs) on the effects of TCC in relieving treatment-related side effects and quality of life in women with breast cancer. Methods. RCTs were searched in PubMed, Embase, Web of Science, and Cochrane Library through April 2014. Data were analyzed on pathology (pain, interleukin-6, and insulin-like growth factor 1), physical capacity (handgrip, limb physical fitness, and BMI), and well-being (physical, social, emotional, and general quality of life). Results. Nine RCTs, including a total of 322 breast cancer patients, were examined. Compared with control therapies, the pooled results suggested that TCC showed significant effects in improving handgrip dynamometer strength, limb elbow flexion (elbow extension, abduction, and horizontal adduction). No significant differences were observed in pain, interleukin-6, insulin-like growth factor, BMI, physical well-being, social or emotional well-being, or general health-related quality of life. Conclusion. The short-term effects of TCC may have potential benefits in upper limb functional mobility in patients with breast cancer. Additional randomized controlled trials with longer follow-up are needed to provide more reliable evidence.
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Abstract
Being diagnosed with a life-threatening disease such as cancer and undergoing treatment can cause unwanted distress and interferes with quality of life. Uncontrolled stress can have a negative effect on a number of biological systems and processes leading to negative health outcomes. While some distress is normal, it is not benign and must be addressed, as failure to do so may compromise health and QOL outcomes. We present the evidence for the role of stress in cancer biology and mechanisms demonstrating how distress is associated with worse clinical outcomes. The National Comprehensive Cancer Network states that all patients be screened with the single-item distress thermometer and to also indicate the source of distress and to get appropriate referral. In addition to the many conventional approaches for managing distress from the fields of psychology and psychiatry, many patients are seeking strategies to manage their distress that are outside conventional medicine such as mind-body techniques. Mind-body techniques such as meditation, yoga, tai chi, and qigong have been found to lower distress and lead to improvements in different aspects of quality of life. It is essential that the standard of care in oncology include distress screening and the delivery of different techniques to help patients manage the psychosocial challenges of diagnosis and treatment of cancer.
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Affiliation(s)
- Alejandro Chaoul
- Department of General Oncology, Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kathrin Milbury
- Department of General Oncology, Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Anil K. Sood
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sarah Prinsloo
- Department of General Oncology, Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lorenzo Cohen
- Department of General Oncology, Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX,Corresponding Author: ; Tel: 713-745-4260; Fax: 713-745-2437
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Song HY, Kwon JA, Choi JW, Kim SJ, Park EC. Gender Differences in Marital Disruption among Patients with Cancer: Results from the Korean National Health and Nutrition Examination Survey (KNHANES). Asian Pac J Cancer Prev 2014; 15:6547-52. [DOI: 10.7314/apjcp.2014.15.16.6547] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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