Affective responses after different intensities of exercise in patients with traumatic brain injury

Background: Patients with traumatic brain injury (TBI) usually have mood and anxiety symptoms secondary to their brain injury. Exercise may be a cost-effective intervention for the regulation of the affective responses of this population. However, there are no studies evaluating the effects of exercise or the optimal intensity of exercise for this clinical group.

Methods: Twelve male patients with moderate or severe TBI [mean age of 31.83 and SD of 9.53] and 12 age- and gender-matched healthy volunteers [mean age of 30.58 and SD of 9.53] participated in two sessions of exercise of high and moderate-intensity. Anxiety and mood was evaluated, and subjective assessment of experience pre- and post-exercise was assessed. A mixed between and within-subjects general linear model (GLM) analysis was conducted to compare groups [TBI, control] over condition [baseline, session 1, session 2] allowing for group by condition interaction to be determined. Planned comparisons were also conducted to test study hypotheses.

Results: Although no group by condition interaction was observed, planned comparisons indicated that baseline differences between patients and controls in anxiety (Cohens’ d = 1.80), tension (d = 1.31), depression (d = 1.18), anger (d = 1.08), confusion (d = 1.70), psychological distress (d = 1.28), and physical symptoms (d = 1.42) disappear after one session of exercise, independently of the intensity of exercise.

Conclusion: A single-section of exercise, regardless of exercise intensity, had a positive effect on the affective responses of patients with TBI both by increasing positive valence feelings and decreasing negative ones. Exercise can be an easily accessible intervention that may alleviate depressive symptoms related to brain injury.

Abstract P4-07-10: Effect of acupuncture and exercise therapy on muscular strength, lymphedema and quality of life in breast cancer survivors: randomized clinical trial

Introduction: The continuous advance in the early detection and treatment of breast cancer has significantly reduced mortality and, consequently, increased the number of survivors with treatment side effects that act on the quality of life, such as lymphedema, loss of upper limb strength, shoulder dysfunction, decreased functional capacity, flexibility, and joint mobility. Exercise therapy is a recognized practice for the rehabilitation of these disorders; however, acupuncture needs to be better evaluated to compare its equivalence with classical therapy. Objective: To compare three distinct rehabilitation treatments (exercise therapy, acupuncture and Stiper®) in women undergoing breast cancer surgery, assessing strength, lymphedema and quality of life. Methods: Seventy-nine women with pain above 3 on the visual analogue pain scale (VAS) and with more than 90 days of surgery were included. They were divided into three groups that received weekly treatment for 10 weeks: group I (G1) treated with standard, pre-defined exercise therapy, based on stretching of the cervical muscles, shoulder girdle and shoulder ROM exercises with a duration of 30 minutes, group II (G2) treated with 30 minutes of acupuncture using predefined points and group III (G3) treated with the same acupuncture points as group II, however, using the Stiper® (silicon oxide micronized quartz pellet) in place of needles. Results: Sixty-seven patients completed the treatment, being 26 from G1, 23 from G2 and 18 from G3. There was an improvement in upper limb muscle strength over time in all groups, except for abduction and internal rotation movements. During treatment, there was no increase in the number of patients with lymphedema and there was no statistical difference between the groups. Regarding the EORTC QLQ-C30 quality of life questionnaire, nine of the fifteen factors analyzed showed significant differences between sessions. The factors that did not have significant differences between the three groups were Social Function, Nausea and Vomiting, Dyspnea, Loss of Appetite, Constipation and Diarrhea. Conclusion: The rehabilitation of physical dysfunctions in women who survived breast cancer through exercise therapy, acupuncture and Stiper® in upper limb muscle strength, lymphedema and quality of life, proved to be effective, without difference between groups, which leads to the conclusion that acupuncture didn’t show superiority of results when compared with exercise therapy, thus being an effective approach for the rehabilitation of these women.

Citation Format: Patricia Santolia, Gil Facina, Cinira Haddad, Samantha K. Lopes de Almeida Rizzi, Afonso Nazário, Simone Elias. Effect of acupuncture and exercise therapy on muscular strength, lymphedema and quality of life in breast cancer survivors: randomized clinical trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-10.

Abstract P4-07-43: Effect of acupuncture and exercise therapy in rehabilitation of physical disfunctions in breast cancer survivors: randomized clinical trial

Introduction: The treatment of breast cancer can trigger physical dysfunctions and psychological difficulties such as pain, depression, limitation of upper limb function and shoulder range of motion (ROM) deficits. Exercise therapy is a treatment well established in the literature for these disorders and another form of treatment is acupuncture. However, most studies using acupuncture only assess pain. Objective: To compare three distinct rehabilitation treatments (exercise therapy, acupuncture and Stiper®) in women undergoing breast cancer surgery, assessing pain, depression, upper limb function and range of motion parameters (ROM). Methods: Seventy-nine women with pain above 3 on the visual analogue pain scale (VAS) and with more than 90 days of surgery were included. They were divided into three groups that received weekly treatment for 10 weeks: group I (G1) treated with standard, pre-defined exercise therapy, based on stretching of the cervical muscles, shoulder girdle and shoulder ROM exercises with a duration of 30 minutes, group II (G2) treated with 30 minutes of acupuncture using predefined points and group III (G3) treated with the same acupuncture points as group II, however, using the Stiper ® (silicon oxide micronized quartz pellet) in place of needles. Results: Sixty-seven patients completed the treatment, being 26 from G1, 23 from G2 and 18 from G3. There was an improvement of pain over time in all groups (first session compared with the fifth (p < 0.001) and with the tenth (p < 0.001), but not between groups. There was a statistically significant difference in depressive symptoms using the Beck questionnaire over time in the three groups (between the first and tenth sessions (p = 0.001), between the first and fifth sessions (p = 0.052), but not between groups. Regarding the DASH questionnaire for shoulder function, there were significant differences overtime at all evaluated moments (p< 0.001), but not between groups. There was a statistically significant difference in ROM over time in the three groups, but not between groups. Conclusion: The rehabilitation of physical dysfunctions in women who survived breast cancer through exercise therapy, acupuncture and Stiper® in pain, depression, upper limb function and ROM, proved to be effective, without statistically difference between the groups, which in leads to the conclusion that acupuncture don’t showed the superiority of results when compared with exercise therapy, thus being an effective approach in the rehabilitation of these women.

Citation Format: Patricia Santolia, Gil Facina, Cinira Haddad, Afonso Nazário, Samantha K. Lopes de Almeida Rizzi, Simone Elias. Effect of acupuncture and exercise therapy in rehabilitation of physical disfunctions in breast cancer survivors: randomized clinical trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-43.