Exercise regimens for improved sleep quality in adult breast cancer survivors: systematic review and network meta-analysis.

OBJECTIVE: The relative efficacy of exercise regimens for improving sleep quality in adult breast cancer survivors remains unknown. This network meta-analysis aimed to compare the efficacy of various exercise regimens for improving sleep quality in adult breast cancer survivors. METHODS: This study searched four electronic databases for relevant literature from inception to 18 July 2023. Randomised controlled trials reporting the effects of exercise on sleep quality in adults with breast cancer were included. A random-effects network meta-analysis based on the frequentist framework was performed. RESULTS: In total, 35 trials including 3374 breast cancer survivors were included. Compared with usual care, endurance training combined with resistance training significantly improved sleep quality (standardised mean differences (SMDs) = -0.97; 95% CI = -1.50 to -0.43; certainty of evidence=moderate) (p<0.05). Endurance training combined with resistance training (SMDs: -1.42; 95% CIs: -2.31 to -0.53; moderate) achieved superior sleep quality results compared with stretching exercises (p<0.05). The surface under the cumulative ranking curve analysis indicated that endurance training combined with resistance training was ranked as the top effective treatment among other exercise regimens for improving sleep quality in breast cancer survivors (71%). CONCLUSIONS: Endurance training combined with resistance training is effective in improving sleep quality in adult breast cancer survivors. Our results provide evidence that exercise can improve sleep quality in adult breast cancer survivors.

Comparative effects of warming systems applied to different parts of the body on hypothermia in adults undergoing abdominal surgery: A systematic review and network meta-analysis of randomized controlled trials.

STUDY OBJECTIVE: The prevention of perioperative hypothermia after anesthesia induction is a critical concern in patients undergoing abdominal surgery. The effectiveness of various warming systems for preventing hypothermia and shivering when applied to specific areas of the body remains undetermined. DESIGN: Systematic review and network meta-analysis. SETTING: Operating room. INTERVENTION: Five electronic databases were searched, including only randomized control trials (RCTs) reporting the effects of warming systems applied to specific body sites on the intraoperative core temperature and postoperative risk of shivering in adults undergoing abdominal surgery. A multivariate random-effects network meta-analysis with a frequentist framework was implemented for data analysis. MEASUREMENTS: The primary outcome was the core body temperature 60 and 120 min after anesthesia induction for abdominal surgery. The secondary outcome was the incidence of postoperative shivering. RESULTS: This review comprised a total of 24 RCTs including 1119 patients. At 60 and 120 min after anesthesia induction, a forced-air warming system applied to the upper body (0.3 °C and 95% confidence intervals = [0.3 to 0.4], 1.0 °C [0.7 to 1.3]), lower body (0.4 °C [0.3 to 0.5], 0.9 °C [0.5 to 1.2]), and underbody (0.5 °C [0.5 to 0.6], 1.2 °C [0.9 to 1.6]) was superior to passive insulation in terms of core body temperature regulation. Compared with passive insulation, the forced-air warming system applied to the lower body (odds ratio = 0.06) or underbody (0.44) and the electric heating blanket to the lower body (0.02) or the whole body (0.07) significantly reduced the risk of shivering. CONCLUSIONS: The results of this NMA revealed that forced-air warming with an underbody blanket effectively elevates core body temperatures in 60 and 120 min after induction of anesthesia and prevents shivering in patients recovering from abdominal surgery.

The Effect of Acupressure on Relieving Cancer-Related Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Fatigue, a common complaint reported by patients with cancer or in survivorship, has been negatively associated with quality of life, emotional health, and cognitive functions. Acupressure, a traditional Chinese medicine, has been increasingly practiced in clinical and community settings. However, little evidence supports the beneficial effects of acupressure on the reduction of general, physical, and mental fatigue in cancer survivors. OBJECTIVE: The aim of this study was to examine the effect of acupressure on fatigue in cancer survivors and the moderators of the effect of acupressure on cancer-related fatigue relief. METHODS: Databases, namely, PubMed, Embase, CINAHL, and ProQuest, were searched from their inception to July 17, 2020. No language and publication period restrictions were applied. Only randomized controlled trials that examined the effects of acupressure on cancer-related fatigue were included. A random-effects model was used for data analyses. RESULTS: Fourteen articles involving 776 participants with cancers were included. Acupressure considerably alleviated cancer-related general, physical, and mental fatigue (g = -0.87, -0.87, and -0.37) compared with controls. Increasing female percentage of participants significantly reduced the effects of acupressure on fatigue (B = -0.01, P < .001). The executor and operation approach as well as treatment period during chemotherapy did not moderate the effects of acupressure on fatigue relief. CONCLUSION: Acupressure is effective at alleviating cancer-related fatigue. IMPLICATIONS FOR PRACTICE: Health professionals and patients can use acupressure to alleviate fatigue during and after chemotherapy. Nursing personnel could incorporate acupressure into clinical practice as part of a multimodal approach to alleviating fatigue in cancer survivors.