OBJECTIVE: This study is aimed at evaluating the effect of Chinese traditional Wushu (CTW) on cancer-related fatigue (CRF), sleep quality, and upper limb dysfunction. Data Sources. We searched studies containing randomized controlled trials up to July 2021 in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang database, and China Biological Medicine on this topic.
METHODS: A randomized controlled trial of CTW on major outcome indicators such as CRF, sleep quality, and upper limb dysfunction of breast cancer survivors. Study screening, data extraction, and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted with Stata 16.0 software. The quality of the evidence was assessed by the Cochrane Collaboration Risk of Bias (ROB2.0).
RESULTS: Eighteen studies met the requirements for meta-analysis (n = 1331). We found that CTW has no obvious effect on improving breast cancer survivors' CRF (SMD = -0.733; P = 0.059; I 2 = 89.3%), but it can effectively improve their sleep quality (WMD = -2.266; P = 0.022; I 2 = 99.2%) and upper limb dysfunction (SMD = 1.262; P ≤ 0.001; I 2 = 88.5%).
CONCLUSION: Although more studies on this topic are needed to prove the effectiveness of this method, the results of our review show that CTW is significantly helpful for better sleep and upper limb dysfunction. But the effects on CRF will need to be confirmed further. Implications for Cancer Survivors. In the future intervention process, to verify the effectiveness of CTW on improving CRF for breast cancer survivors, it would be suggested to pay close attention to breast cancer survivors' response to exercise, achieve regular follow-up, strictly conduct the intervention scheme on the premise of ensuring absolute security, and reduce the loss of intervention objects.
Objective. This paper aims to systematically evaluate the intervention effect of mind-body exercise on cancer-related fatigue in breast cancer patients. Methods. Databases including PubMed, the Cochrane Library, Embase, Web of Science, CNKI, Wanfang Data, and SINOMED were retrieved to collect randomized controlled trials on the effects of mind-body exercise on relieving cancer-related fatigue in breast cancer patients. The retrieval period started from the founding date of each database to January 6, 2021. Cochrane bias risk assessment tools were used to evaluate the methodological quality assessment of the included literature, and RevMan 5.3 software was used for meta-analyses. Results. 17 pieces of researches in 16 papers were included with a total of 1133 patients. Compared with the control group, mind-body exercise can improve cancer-related fatigue in breast cancer patients. The combined effect size SMD = 0.59, 95% CI was [0.27, 0.92], p<0.00001. Doing Tai Chi for over 40 minutes each time with an exercise cycle of ≤6 weeks can improve cancer-related fatigue in breast cancer patients more significantly. Sensitivity analysis shows that the combined effect results of the meta-analysis were relatively stable. Conclusion. Mind-body exercise can effectively improve cancer-related fatigue in breast cancer patients.
IMPORTANCE: Cancer-related fatigue (CRF) remains one of the most prevalent and troublesome adverse events experienced by patients with cancer during and after therapy.
OBJECTIVE: To perform a meta-analysis to establish and compare the mean weighted effect sizes (WESs) of the 4 most commonly recommended treatments for CRF-exercise, psychological, combined exercise and psychological, and pharmaceutical-and to identify independent variables associated with treatment effectiveness.
DATA SOURCES: PubMed, PsycINFO, CINAHL, EMBASE, and the Cochrane Library were searched from the inception of each database to May 31, 2016.
STUDY SELECTION: Randomized clinical trials in adults with cancer were selected. Inclusion criteria consisted of CRF severity as an outcome and testing of exercise, psychological, exercise plus psychological, or pharmaceutical interventions.
DATA EXTRACTION AND SYNTHESIS: Studies were independently reviewed by 12 raters in 3 groups using a systematic and blinded process for reconciling disagreement. Effect sizes (Cohen d) were calculated and inversely weighted by SE.
MAIN OUTCOMES AND MEASURES: Severity of CRF was the primary outcome. Study quality was assessed using a modified 12-item version of the Physiotherapy Evidence-Based Database scale (range, 0-12, with 12 indicating best quality).
RESULTS: From 17 033 references, 113 unique studies articles (11 525 unique participants; 78% female; mean age, 54 [range, 35-72] years) published from January 1, 1999, through May 31, 2016, had sufficient data. Studies were of good quality (mean Physiotherapy Evidence-Based Database scale score, 8.2; range, 5-12) with no evidence of publication bias. Exercise (WES, 0.30; 95% CI, 0.25-0.36; P < .001), psychological (WES, 0.27; 95% CI, 0.21-0.33; P < .001), and exercise plus psychological interventions (WES, 0.26; 95% CI, 0.13-0.38; P < .001) improved CRF during and after primary treatment, whereas pharmaceutical interventions did not (WES, 0.09; 95% CI, 0.00-0.19; P = .05). Results also suggest that CRF treatment effectiveness was associated with cancer stage, baseline treatment status, experimental treatment format, experimental treatment delivery mode, psychological mode, type of control condition, use of intention-to-treat analysis, and fatigue measures (WES range, -0.91 to 0.99). Results suggest that the effectiveness of behavioral interventions, specifically exercise and psychological interventions, is not attributable to time, attention, and education, and specific intervention modes may be more effective for treating CRF at different points in the cancer treatment trajectory (WES range, 0.09-0.22).
CONCLUSIONS AND RELEVANCE: Exercise and psychological interventions are effective for reducing CRF during and after cancer treatment, and they are significantly better than the available pharmaceutical options. Clinicians should prescribe exercise or psychological interventions as first-line treatments for CRF.
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, <i>P</i> < 0.05), whereas Tai Chi and Qigong had no effect on QOL of breast cancer survivors (<i>P</i> > 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; <i>P</i> = 0.97; I² = 36%) and mood distress (<i>P</i> > 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. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
PURPOSE: Evidence suggests a high prevalence of sleep-wake disturbances in patients with cancer, occurring at diagnosis, during treatment, and continuing to survivorship. Yet associations between sleep-wake disturbances and the impact on quality of life outcomes is less clear. The purpose of this narrative review of the literature is to evaluate sleep-wake disturbances in patients with cancer, to describe the influence of poor sleep on quality of life as an outcome, and to evaluate the evidence to recommend future interventions.
FRAMEWORK AND METHODS: This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach. Four databases (CINAHL, MEDLINE, PsycINFO, and Embase) were searched using terms "cancer OR neoplasm", "sleep, sleep disturbance, sleep disorders or insomnia", and "quality of life"; the search included all years, English language, and peer-reviewed articles on research studies. Studies included measurements of sleep and quality of life in cancer patients at a minimum of two time points and demonstrated relationships between sleep and quality of life. Data were collected on date, patient demographics, cancer type and treatment, timeframe, design, measurement, variables, and results.
RESULTS: This narrative review demonstrates that sleep-wake disturbance is a major problem/symptom in patients with cancer. Of the 18 studies included, measurement of sleep-related variables included objective and subjective measures; however, direct measurement of the associations between sleep and quality of life was not common. Cognitive behavioral therapy for insomnia and mind-body interventions demonstrated feasibility when implemented into cancer care settings. In addition, the majority of interventions exhibited moderate effectiveness in improving sleep-wake disturbance and quality of life outcomes.
CONCLUSION: The studies predominantly reported that poor sleep negatively impacts quality of life. The intervention studies included nonpharmacologic interventions such as cognitive behavioral treatment and mind-body and exercise interventions with moderate-to-high levels of evidence for improvement in sleep measures and quality of life.
BACKGROUND: Cancer is a leading cause of death worldwide. Mind-body interventions are widely used by cancer patients to reduce symptoms and cope better with disease- and treatment-related symptoms. In the last decade, many clinical controlled trials of qigong/tai chi as a cancer treatment have emerged. This study aimed to quantitatively evaluate the effects of qigong/tai chi on the health-related outcomes of cancer patients. METHODS: Five databases (Medline, CINAHL, Scopus, the Cochrane Library, and the CAJ Full-text Database) were searched until June 30, 2013. Randomized controlled trials (RCTs) of qigong/tai chi as a treatment intervention for cancer patients were considered for inclusion. The primary outcome for this review was changes in quality of life (QOL) and other physical and psychological effects in cancer patients. The secondary outcome for this review was adverse events of the qigong/tai chi intervention. RESULTS: A total of 13 RCTs with 592 subjects were included in this review. Nine RCTs involving 499 subjects provided enough data to generate pooled estimates of effect size for health-related outcomes. For cancer-specific QOL, the pooled weighted mean difference (WMD) was 7.99 [95% confidence interval (CI): 4.07, 11.91; Z score=4.00, p<0.0001]. The standardized mean differences (SMDs) for changes in depression and anxiety score were -0.69 (95% CI: -1.51, 0.14; Z score=1.64, p=0.10), and -0.93 (95% CI: -1.80, -0.06; Z score=2.09, p=0.04), respectively. The WMDs for changes in body mass index and body composition from baseline to 12 weeks follow-up were -1.66 (95% CI: -3.51, 0.19; Z score=1.76, p=0.08), and -0.67 (95% CI: -2.43, 1.09; Z score=0.75, p=0.45) respectively. The SMD for changes in the cortisol level was -0.37 (95% CI: -0.74, -0.00; Z score=1.97, p=0.05). CONCLUSION: This study found that qigong/tai chi had positive effects on the cancer-specific QOL, fatigue, immune function and cortisol level of cancer patients. However, these findings need to be interpreted cautiously due to the limited number of studies identified and high risk of bias in included trials. Further rigorous trials are needed to explore possible therapeutic effects of qigong/tai chi on cancer patients.
This study is aimed at evaluating the effect of Chinese traditional Wushu (CTW) on cancer-related fatigue (CRF), sleep quality, and upper limb dysfunction. Data Sources. We searched studies containing randomized controlled trials up to July 2021 in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang database, and China Biological Medicine on this topic.
METHODS:
A randomized controlled trial of CTW on major outcome indicators such as CRF, sleep quality, and upper limb dysfunction of breast cancer survivors. Study screening, data extraction, and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted with Stata 16.0 software. The quality of the evidence was assessed by the Cochrane Collaboration Risk of Bias (ROB2.0).
RESULTS:
Eighteen studies met the requirements for meta-analysis (n = 1331). We found that CTW has no obvious effect on improving breast cancer survivors' CRF (SMD = -0.733; P = 0.059; I 2 = 89.3%), but it can effectively improve their sleep quality (WMD = -2.266; P = 0.022; I 2 = 99.2%) and upper limb dysfunction (SMD = 1.262; P ≤ 0.001; I 2 = 88.5%).
CONCLUSION:
Although more studies on this topic are needed to prove the effectiveness of this method, the results of our review show that CTW is significantly helpful for better sleep and upper limb dysfunction. But the effects on CRF will need to be confirmed further. Implications for Cancer Survivors. In the future intervention process, to verify the effectiveness of CTW on improving CRF for breast cancer survivors, it would be suggested to pay close attention to breast cancer survivors' response to exercise, achieve regular follow-up, strictly conduct the intervention scheme on the premise of ensuring absolute security, and reduce the loss of intervention objects.
