RESUMEN
PURPOSE: Previous research incorporating yoga (YG) into radiotherapy (XRT) for women with breast cancer finds improved quality of life (QOL). However, shortcomings in this research limit the findings. PATIENTS AND METHODS: Patients with stages 0 to III breast cancer were recruited before starting XRT and were randomly assigned to YG (n = 53) or stretching (ST; n = 56) three times a week for 6 weeks during XRT or waitlist (WL; n = 54) control. Self-report measures of QOL (Medical Outcomes Study 36-item short-form survey; primary outcomes), fatigue, depression, and sleep quality, and five saliva samples per day for 3 consecutive days were collected at baseline, end of treatment, and 1, 3, and 6 months later. RESULTS: The YG group had significantly greater increases in physical component scale scores compared with the WL group at 1 and 3 months after XRT (P = .01 and P = .01). At 1, 3, and 6 months, the YG group had greater increases in physical functioning compared with both ST and WL groups (P < .05), with ST and WL differences at only 3 months (P < .02). The group differences were similar for general health reports. By the end of XRT, the YG and ST groups also had a reduction in fatigue (P < .05). There were no group differences for mental health and sleep quality. Cortisol slope was steepest for the YG group compared with the ST and WL groups at the end (P = .023 and P = .008) and 1 month after XRT (P = .05 and P = .04). CONCLUSION: YG improved QOL and physiological changes associated with XRT beyond the benefits of simple ST exercises, and these benefits appear to have long-term durability.
Asunto(s)
Neoplasias de la Mama/psicología , Neoplasias de la Mama/radioterapia , Calidad de Vida , Yoga , Adulto , Anciano , Neoplasias de la Mama/metabolismo , Depresión/prevención & control , Disomnias/prevención & control , Fatiga/prevención & control , Femenino , Humanos , Hidrocortisona/metabolismo , Persona de Mediana Edad , Ejercicios de Estiramiento Muscular , Calidad de Vida/psicología , Saliva/metabolismoRESUMEN
OBJECTIVE: To determine if participation in a pulmonary rehabilitation (PR) program improved the functional and physiologic status of oncology patients with chronic symptoms of shortness of breath, fatigue, and/or exercise intolerance. DESIGN: Retrospective chart review. SETTING: Comprehensive cancer center. PATIENTS: Oncology patients (N=30) (either a solid or a hematologic malignancy) with chronic dyspnea, exercise intolerance, and/or decreased functional status who had participated in an outpatient PR program. INTERVENTIONS: The PR program used an individualized, progressive aerobic exercise program (2-3 sessions/wk for 8-12 weeks) that consisted of treadmill walking, riding on a bicycle ergometer and exercising on a sliding board. This program also included a didactic educational and psychosocial component. MAIN OUTCOME MEASURES: Functional status and exercise tolerance was assessed by the 6-minute walk test (6MWT) conducted at the beginning and end of the program. Self reports of perceived exertion and dyspnea were collected during and after these tests. Physiologic status was assessed by calculating 6-minute walk work (body mass x 6-minute walk distance). RESULTS: Participation in the outpatient PR program significantly increased the 6-minute walk distance (21%, P<.05) and 6-minute walk work (17%, P<.05). Dyspnea and perceived exertion scores were similar at the pre- and postrehabilitation 6MWT despite the greater physiologic demand of the post-rehabilitation 6-minute walk. No adverse events occurred during the study. CONCLUSIONS: The current study, although limited in size, suggests that participation in a comprehensive outpatient PR program is safe and of benefit in a heterogeneous population of oncology patients with pulmonary symptoms.