Effects of yoga on health-related quality, physical health and psychological health in women with breast cancer receiving chemotherapy: a systematic review and meta-analysis.

BACKGROUND: Yoga receive more attention from breast cancer patients, however its feasibility and efficacy during chemotherapy remains conflicting. We performed this systematic review to assess the effects of yoga on health-related quality, physical health and psychological health in breast cancer patients undergoing chemotherapy. METHODS: A systematic search was conducted to retrieve randomized controlled trials (RCTs) which investigated the comparative efficacy of yoga versus comparators such as usual care among breast cancer patients for health-related quality, physical health and psychological health in PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CNETRAL), Nursing and Allied Health Literature (CINAHL), Chinese Biomedical Literature (CBM) Database, China Science and Technology Journal (CSTJ) Database, China National Knowledge Infrastructure (CNKI), and Wangfang Database from inception to December 2018. The latest search was updated on September 2020. All analyses were completed using RevMan version 5.3. RESULTS: Seven trials involving 693 breast cancer patients met inclusion criteria. Meta-analysis indicated a short-term improvement in fatigue [standard mean difference (SMD), -0.62; 95% confidence interval (CI), -1.17 to -0.07], sleep disturbance (SMD, -0.34; 95% CI, -0.55 to -0.12), depression (SMD, -0.50; 95% CI, -0.70 to -0.31) anxiety (SMD, -0.50; 95% CI, -0.70 to -0.31), and health-related quality of life (QoL) (SMD, 0.72; 95% CI, -0.12 to 1.56) in the yoga group; however beneficial medium- and long-term effects in fatigue, sleep disturbance were not identified. Moreover, qualitative analyses suggested that yoga was not associated with decreased adverse events (AEs) compared with control groups. CONCLUSIONS: Yoga may benefit to reduce fatigue, depression and anxiety, improve sleep disturbance, and improve QoL in breast cancer patients receiving chemotherapy in the short-term; however, medium- and long-term effects should be further established owing to limitations.