RÉSUMÉ
BACKGROUND: Breast cancer-related lymphedema (BCRL) affects many areas of daily living. Individuals with lymphedema may experience chronic and progressive swelling, recurrent skin infections, and decreased self-image and quality of life. For many years, it was considered best practice for this population to avoid exercise; however, in recent years, research has begun to challenge this belief. This systematic review and meta-analyses examined the recent literature on the effects of exercise for patients with, or at risk for, BCRL to inform best practice. METHODS: A total of 807 articles were retrieved from CINAHL, Academic Search Complete, Medline, and PubMed. Results were systematically filtered to 26 articles through inclusion criteria, exclusion criteria, and the Effective Public Health Practice Project quality assessment tool for quantitative studies. Data were pooled from studies containing relative and absolute volume measurements of limb volume, as well as upper extremity function measured by the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire; meta-analyses were conducted using SAS software. RESULTS: The literature was reviewed and statistically analyzed. Results have indicated aerobic exercise, resistance exercise, stretching, yoga, qigong, and pilates can be safe and effective in the management of symptoms for those with, or at risk for, BCRL. CONCLUSION: Several forms of exercise appear to be safe interventions for clinicians to use when treating this population and offer benefits such as improved quality of life, strength, body mass index, and mental health and decreased pain and lymphatic swelling. Additional research should be conducted to further examine the efficacy and safety of nontraditional forms of exercise in the treatment of BCRL.
Sujet(s)
Lymphoedème après cancer du sein/thérapie , Tumeurs du sein/rééducation et réadaptation , Traitement par les exercices physiques/méthodes , Force musculaire/physiologie , Débit sanguin régional/physiologie , Activités de la vie quotidienne , Lymphoedème après cancer du sein/physiopathologie , Lymphoedème après cancer du sein/psychologie , Femelle , Humains , Guides de bonnes pratiques cliniques comme sujet , Qualité de vie , Entraînement en résistance , Survivants , Résultat thérapeutiqueRÉSUMÉ
PURPOSE/OBJECTIVES: To evaluate a mind-body medicine (MBM) program for its impact on persistent fatigue following breast cancer treatment. DESIGN: Quasiexperimental. SETTING: An urban community hospital and a health department in a semirural county, both in Maryland. SAMPLE: 68 breast cancer survivors who were at least six months postadjuvant chemotherapy and/or radiation therapy and had a baseline fatigue score of 50 or lower per the vitality subscale of the SF-36® Health Survey. METHODS: A 10-week group-based MBM program for breast cancer survivors with persistent fatigue was evaluated using a pretest/post-test study design. MAIN RESEARCH VARIABLES: Sustained change in fatigue severity as measured by the Piper Fatigue Scale (PFS), SF-36 vitality subscale, and 10 cm visual analog scale (VAS). FINDINGS: Participants were 2.6 years post-treatment, with a mean age of 56.8 years. Overall, fatigue scores improved by 40%. The mean PFS improved from a score of 6 (SD = 1.6) at baseline to 4.2 (SD = 2) at the end of the program (p < 0.001), with additional improvement at two months and sustained at six months (X = 3.6, SD = 2, p < 0.001). Results from the SF-36 and VAS also showed significant improvement in fatigue (p < 0.001). CONCLUSIONS: The findings support the use of a holistic MBM intervention to reduce persistent fatigue in breast cancer survivors. Results should be confirmed with a randomized clinical trial. IMPLICATIONS FOR NURSING: Nurses and other healthcare team members can effectively impact persistent fatigue in breast cancer survivors through the use of a multipronged MBM program.